Healthcare Provider Details

I. General information

NPI: 1841101664
Provider Name (Legal Business Name): JP CONCIERGE PSYCHIATRY, PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 W MISSION RD STE 305
ALHAMBRA CA
91803-1434
US

IV. Provider business mailing address

2108 N ST STE N
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 909-257-7268
  • Fax:
Mailing address:
  • Phone: 909-257-7268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JULIE PHAM
Title or Position: CEO
Credential: MD
Phone: 909-257-7268