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NPI Code Detail

MEDICARE: JESSI H PHAM

MEDICARE:   JESSI H 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
1101YM0800XMental Health Counselor21886CA
2106H00000XMarriage & Family Therapist161531CA
3171400000XHealth & Wellness Coach297077F429CA

General Provider Information

NPI Number : 1972479400
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSI H PHAM
Provider Business Mailing Address
First Line : 1010 N MAIN ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92701-3602
Country : US
Telephone Number : 714-560-0900
Fax Number :
Provider Business Practice Location Address
First Line : 1010 N MAIN ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92701-3602
Country : US
Telephone Number : 714-560-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2025
Last Update Date : 02/10/2026

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Directions to “ JESSI H PHAM ” Practice Location

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