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General NPI Number Information
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NPI Number | 1417743261
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Entity Type | Individual
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Provider Name | JOANNA HA PHAM
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Gender | Female
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 9781 BLUE LARKSPUR LN STE 100
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City | MONTEREY
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State | CA
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Zip | 93940-6509
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Country | US
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Telephone | 831-333-9008
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Fax | 831-333-9010
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Provider Business Mailing Address
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Address Line | 47 NEW SCOTLAND AVE # MC-4
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City | ALBANY
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State | NY
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Zip | 12208-3412
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Country | US
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Telephone | 518-262-5251
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Fax | 518-262-0484
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 66631
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License Number State | CA
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