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General NPI Number Information
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NPI Number | 1962275909
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Entity Type | Individual
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Provider Name | VI T PHAM NEGRETE PSYD
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Gender | Female
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 680 E COLORADO BLVD STE 180&2ND
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City | PASADENA
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State | CA
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Zip | 91101-6143
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Country | US
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Telephone | 909-235-9532
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Fax |
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Provider Business Mailing Address
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Address Line | 5150 MAE ANNE AVE STE 405, PMB 3035
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City | RENO
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State | NV
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Zip | 89523
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Country | US
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Telephone | 909-235-9532
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 94026787
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY34705
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License Number State | CA
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