Healthcare Provider Details

I. General information

NPI: 1053444570
Provider Name (Legal Business Name): VINH PHU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 9TH ST
SAN FRANCISCO CA
94103-2603
US

IV. Provider business mailing address

1385 MISSION ST SUITE 240
SAN FRANCISCO CA
94103-2623
US

V. Phone/Fax

Practice location:
  • Phone: 158-630-4874
  • Fax: 415-861-2715
Mailing address:
  • Phone: 415-864-4002
  • Fax: 415-864-7093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: