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NPI Code Detail

MEDICARE: TINA THUY-HANG THI PHAM

MEDICARE: TINA THUY-HANG THI PHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1942522438
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA THUY-HANG THI PHAM
Provider Business Mailing Address
First Line : 210 N 4TH ST STE 100
Second Line :
City : SAN JOSE
State : CA
Zip : 95112-5573
Country : US
Telephone Number : 408-295-5288
Fax Number : 408-292-1029
Provider Business Practice Location Address
First Line : 210 N 4TH ST STE 100
Second Line :
City : SAN JOSE
State : CA
Zip : 95112-5573
Country : US
Telephone Number : 408-295-5288
Fax Number : 408-292-1029
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2010
Last Update Date : 02/24/2010

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Directions to “ TINA THUY-HANG THI PHAM ” Practice Location

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