LUIS F FONG (NPI# 1598259467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1598259467 |
Entity Type | Individual |
Full Name | LUIS F FONG |
Credential | PMHNP |
Practice Address |
3620 N. 3rd Street Phoenix AZ 85012 |
Mailing Address |
3620 N 3rd St Phoenix AZ 85012-2020 |
Practice Telephone | 6022307373 |
Mailing Telephone | 6022307373 |
Enumeration Date | 2018-06-14 |
Last Update Date | 2020-01-27 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
RN177607 | AZ | Nursing Service Providers |
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP11445 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508155862 | Luis Gustavo Fong | Specialist | 9834 Alstyne Ave, Floor 2, Corona, NY 11368-2720 | 2011-04-07 |
1104968809 | Luis Fong | Student in an Organized Health Care Education/Training Program | 200 1st St Sw, Rochester, MN 55905-0001 | 2007-02-12 |
Street Address |
3620 N. 3RD STREET |
City | PHOENIX |
State | AZ |
Zip Code | 85012 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
1982097614 | T. M. Barratt | Psychologist | 3550 N. Central Ave. Suite 1407, Phoenix, AZ 85012 | 2015-03-04 |
Find all providers in zip 85012 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215536479 | Yolanda D Baugh | Nurse Practitioner | 2625 W Piedmont Rd, Phoenix, AZ 85041-9540 | 2020-10-20 |
1306450960 | Williamsconsultant Com LLC | Nurse Practitioner | 2303 N 44th St Ste 12-1043, Phoenix, AZ 85008-2442 | 2020-09-01 |
1912515305 | Victory Health Solution LLC | Nurse Practitioner | 9132 W Hubbell St, Phoenix, AZ 85037-4377 | 2020-07-21 |
1700494374 | Vanessa Moe | Nurse Practitioner | 42949 N Voyage Trl, Phoenix, AZ 85086-8040 | 2020-07-20 |
1043838527 | Latasha Lynne Freeman | Nurse Practitioner | 1919 E Thomas Rd Bldg 5th, Phoenix, AZ 85016-7710 | 2020-07-10 |
1861019416 | Gayle Cecilia Bachelier | Nurse Practitioner | 2302 N Central Ave Unit 303, Phoenix, AZ 85004-1373 | 2020-06-30 |
1871119156 | Ashlyn Tellers | Nurse Practitioner | 21438 N 33rd Ave, Phoenix, AZ 85027-2241 | 2020-06-22 |
1770109605 | Hannah Carita Jurekovic-byrd | Nurse Practitioner | 5727 N 7th St Ste 308, Phoenix, AZ 85014-5817 | 2020-06-16 |
1578188025 | Joseph Medlin | Nurse Practitioner | 915 N 52nd St Apt 2010, Phoenix, AZ 85008-7934 | 2020-06-10 |
1750901088 | Foothills Psychiatric Services Pllc | Nurse Practitioner | 3546 E Windmere Dr, Phoenix, AZ 85048-7211 | 2020-04-16 |
Find all providers in PHOENIX |
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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.