DIEP PHAN (NPI# 1548741176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548741176 |
| Entity Type | Individual |
| Full Name | DIEP PHAN |
| Practice Address |
7720 Lorraine Ave Ste 102 Stockton CA 95210-4203 |
| Mailing Address |
9485 Heinlein Ct Sacramento CA 95829-6094 |
| Practice Telephone | 2099578787 |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 41006 | CA | Student, Health Care |
| Street Address |
7720 LORRAINE AVE STE 102 |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210-4203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124681416 | Egor Mikhaylovskiy | Student in an Organized Health Care Education/Training Program | 7720 Lorraine Ave Ste 102, Stockton, CA 95210-4203 | 2019-04-22 |
| 1174097109 | Trinh Minh Nguyen | Pharmacist | 7720 Lorraine Ave Ste 102, Stockton, CA 95210-4203 | 2019-01-12 |
| 1851862262 | Van Duong | Pharmacist | 7720 Lorraine Ave Ste 102, Stockton, CA 95210-4203 | 2018-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
| 1043866692 | Alexis Thomasson | Behavior Technician | 7109 Danny Drive, Stockton, CA 95210 | 2019-08-09 |
| 1821651324 | Maria Guadalupe Toledo | Lactation Consultant, Non-RN | 7912 Hammer Lane, Stockton, CA 95210 | 2019-04-19 |
| 1508226440 | Active Life Adult Day Care, Inc. | Clinic/Center | 7209 Tam O'shanter Dr., Stockton, CA 95210 | 2016-03-04 |
| 1548631260 | Rachel Standley | Substance Abuse Rehabilitation Facility | 8017 El Cajon St, Stockton, CA 95210 | 2015-10-08 |
| 1225435308 | Active Life Medical Produtcs Inc | Durable Medical Equipment & Medical Supplies | 611 W Grider Way, Stockton, CA 95210 | 2014-12-04 |
| 1942633318 | Kimberly Ruiz Dizon | Physician Assistant | 1530 E Hammer Ln, Stockton, CA 95210 | 2013-08-20 |
| 1285920983 | Supplemental Health Care | Preferred Provider Organization | 8425 Kiltie Wy, Stockton, CA 95210 | 2011-06-22 |
| 1770807901 | Stockton Medical Weight Loss Center Inc | Internal Medicine | 1801 E. March Lane, Suite 400d, Stockton, CA 95210 | 2010-03-17 |
| 1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
| Find all providers in zip 95210 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
| 1083223317 | Simone A Stevens | Student in an Organized Health Care Education/Training Program | 2041 Grey Stone Dr, Stockton, CA 95206-4652 | 2020-07-22 |
| 1497381453 | Carrie Elaine Guidry | Student in an Organized Health Care Education/Training Program | 4415 N Pershing Ave Apt 4, Stockton, CA 95207-6955 | 2020-03-20 |
| 1740820786 | Brandon Jay Baccam | Student in an Organized Health Care Education/Training Program | 3302 Rutherford Dr, Stockton, CA 95212-3425 | 2020-01-07 |
| 1144886375 | Linda Voeuth Kong | Student in an Organized Health Care Education/Training Program | 3830 Alvarado Ave Apt 225, Stockton, CA 95204-2324 | 2019-05-13 |
| 1518439173 | Heidi Lee | Student in an Organized Health Care Education/Training Program | 3591 Quail Lakes Dr Apt 33, Stockton, CA 95207-5253 | 2018-12-20 |
| 1396220331 | Evangelina Dori Olson | Student in an Organized Health Care Education/Training Program | 1803 W March Ln Ste C&d, Stockton, CA 95207-6414 | 2018-09-25 |
| 1457885279 | Angud Mehdi | Student in an Organized Health Care Education/Training Program | 6351 Saint Andrews Dr, Stockton, CA 95219-1861 | 2017-04-18 |
| 1477929453 | Manjot Kaur Sandhu | Student in an Organized Health Care Education/Training Program | 5405 N Pershing Ave Ste C1, Stockton, CA 95207-5451 | 2015-08-13 |
| 1740662469 | Maha Abdulla | Student in an Organized Health Care Education/Training Program | 6076 Silveroak Cir, Stockton, CA 95219-7186 | 2015-06-18 |
| Find all providers in STOCKTON | ||||
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| 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.