DR. LILIE MYTRANG PHAM (NPI# 1144504317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144504317 |
| Entity Type | Individual |
| Full Name | DR. LILIE MYTRANG PHAM |
| Other Name | MYTRANG THI NGUYEN |
| Credential | DNP, FNP-C |
| Practice Address |
1080 Emeline Ave Santa Cruz CA 95060-1966 |
| Practice Telephone | 8314544100 |
| Practice Fax Number | 8314544488 |
| Mailing Telephone | 4022015146 |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2020-03-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95008298 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 115a Coral St, Santa Cruz, CA 950602131 | 8314542080 |
| Street Address |
1080 EMELINE AVE |
| City | SANTA CRUZ |
| State | CA |
| Zip Code | 95060-1966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730188608 | Marion Joanna Jordan | Physician Assistant | 1080 Emeline Ave, Santa Cruz, CA 95060-1966 | 2005-07-21 |
| 1811526114 | Selena Hudson | Nurse Practitioner | 1080 Emeline Ave, Santa Cruz, CA 95060-1966 | 2020-04-07 |
| 1689219578 | Melinda Marie Martindale | Social Worker | 1080 Emeline Ave, Santa Cruz, CA 95060-1966 | 2019-11-14 |
| 1588225247 | Kirsten Aline Juel | Social Worker | 1080 Emeline Ave, Santa Cruz, CA 95060-1966 | 2019-06-24 |
| 1093248254 | Rashmi Mathew | Internal Medicine | 1080 Emeline Ave, Santa Cruz, CA 95060-1966 | 2017-04-05 |
| 1659810513 | County of Santa Cruz | Clinic/Center | 1080 Emeline Ave, Santa Cruz, CA 95060-1966 | 2017-02-13 |
| 1598156671 | Jose Luis Fernandez | Counselor | 1080 Emeline Ave, Santa Cruz, CA 95060-1966 | 2015-02-11 |
| 1447591078 | Lisa Hernandez | Preventive Medicine | 1080 Emeline Ave, 2nd Floor, Public Health, Santa Cruz, CA 95060-1966 | 2013-03-06 |
| 1578814901 | Jennifer Kelly | Counselor | 1080 Emeline Ave, Santa Cruz, CA 95060-1966 | 2012-09-25 |
| 1972851517 | Matthew James Ventimiglia | Psychologist | 1080 Emeline Ave, Santa Cruz, CA 95060-1966 | 2012-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366940215 | Tiphanie Bowens | Counselor | 380 Encinal St., Suite 200, Santa Cruz, CA 95060 | 2018-01-25 |
| 1942714167 | Kyle Hardwick | Chiropractor | 203 River Street, Santa Cruz, CA 95060 | 2017-11-27 |
| 1972015741 | Nina Marie Francesconi | Acupuncturist | 110 Fern St Apt. C, Santa Cruz, CA 95060 | 2017-11-01 |
| 1679091870 | Laura Evelyn Rochelle | Counselor | 380 Encinal St., Suit 200, Santa Cruz, CA 95060 | 2017-09-07 |
| 1649797903 | Jessica Tarnoff | Counselor | 716 Ocean St., Santa Cruz, CA 95060 | 2017-08-28 |
| 1356862064 | Lakia Niema Queen | Counselor | 542 Ocean Street Suite K, Santa Cruz, CA 95060 | 2017-07-03 |
| 1023555992 | Allison Whitehead | Nurse Practitioner | 1080 Emeline Ave., County of Santa Cruz Health Services Agency, Santa Cruz, CA 95060 | 2017-01-30 |
| 1659827293 | Annabelle Drda | Marriage & Family Therapist | 303 Portero St, Santa Cruz, CA 95060 | 2016-09-01 |
| 1376999698 | Erin Liana Johnson | Counselor | 104 Walnut Avenue, Suite 208, Santa Cruz, CA 95060 | 2016-05-05 |
| 1659732097 | Daniel Ezekiel Contreras | Counselor | 1080 Emeline Building D, Santa Cruz, CA 95060 | 2016-03-13 |
| Find all providers in zip 95060 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497352306 | Erin B O'connor-thygeson | Nurse Practitioner | 311 Olaughlin Rd, Santa Cruz, CA 95065-9694 | 2020-10-04 |
| 1538621131 | Cynthia Davis | Nurse Practitioner | 5019 Thurber Ln, Santa Cruz, CA 95065-1152 | 2019-04-02 |
| 1023555992 | Allison Whitehead | Nurse Practitioner | 1080 Emeline Ave., County of Santa Cruz Health Services Agency, Santa Cruz, CA 95060 | 2017-01-30 |
| 1205285137 | Melody Cantrell | Nurse Practitioner | 125 Claremont Ter, Santa Cruz, CA 95060-1749 | 2016-06-10 |
| 1437480753 | Rebecca A. Mckenzie | Nurse Practitioner | 303 Potrero St Ste 5a, Santa Cruz, CA 95060-2756 | 2010-01-26 |
| 1407848484 | Anne Rice Davis | Nurse Practitioner | 115 Locust St., Santa Cruz, CA 95062-1323 | 2005-08-17 |
| 1033734900 | Kimberly Elliott | Nurse Practitioner | 1662 Dominican Way, Santa Cruz, CA 95065-1522 | 2020-06-16 |
| 1811526114 | Selena Hudson | Nurse Practitioner | 1080 Emeline Ave, Santa Cruz, CA 95060-1966 | 2020-04-07 |
| 1609415728 | Angelika Desimone | Nurse Practitioner | 2907 Chanticleer Ave, Santa Cruz, CA 95065-1815 | 2020-01-06 |
| 1811542863 | Emma Kathleen Kleck | Nurse Practitioner | 250 Locust St, Santa Cruz, CA 95060-3813 | 2019-08-06 |
| Find all providers in SANTA CRUZ | ||||
| City | SANTA CRUZ |
| Zip Code | 95060 |
Please comment or provide details below to improve the information on DR. LILIE MYTRANG PHAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.