DR. JENNIFER NGOC-SON PHAN (NPI# 1801045158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801045158 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER NGOC-SON PHAN |
| Credential | PSY.D. |
| Practice Address |
210 S De Lacey Ave Ste 110 Pasadena CA 91105-2074 |
| Practice Telephone | 6263957100 |
| Mailing Telephone | 6263957100 |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2014-08-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 225C00000X | Rehabilitation Counselor | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396385654 | Jennifer Phan | Behavior Technician | 865 Marina Bay Pkwy Ste 37 & 38, Richmond, CA 94804 | 2020-01-14 |
| 1609372150 | Jennifer Phan | Nurse Practitioner | 1452 Reed Ave, San Diego, CA 92109-5351 | 2018-04-03 |
| 1114333697 | Jennifer Phan | Pharmacist | 6848 Landing Dr, Grand Prairie, TX 75054-6810 | 2014-07-07 |
| 1538443460 | Jennifer Trinh Phan | Nurse Practitioner | 266 Main St Ste 4, Medfield, MA 02052-2018 | 2011-10-11 |
| 1861621880 | Jennifer Phan | Otolaryngology | 3113 N Broadway Street, Anderson, IN 46012-1261 | 2009-07-12 |
| 1376003509 | Jennifer Phan | Student in an Organized Health Care Education/Training Program | 5246 Brittany Dr Fl 3, Baton Rouge, LA 70808-9136 | 2019-03-22 |
| 1023502713 | Jennifer Thuy Phan | Pharmacist | 4810 Lapalco Blvd, Marrero, LA 70072 | 2018-06-18 |
| 1780002055 | Jennifer Phan | Internal Medicine | 200 Medical Plaza Ste 214, Los Angeles, CA 90095-1804 | 2014-04-02 |
| 1205265956 | Jennifer Phan | Pharmacist | 6325 Rosemead Blvd, San Gabriel, CA 91775-1933 | 2013-11-04 |
| 1972930394 | Jennifer Kim Phan | Pharmacist | 1980 Santa Rosa Ave, Santa Rosa, CA 95407 | 2013-09-30 |
| Street Address |
210 S DE LACEY AVE STE 110 |
| City | PASADENA |
| State | CA |
| Zip Code | 91105-2074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467582692 | Noemi Cristina Harnen | Rehabilitation Practitioner | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2007-03-06 |
| 1003314204 | Thomas Mackey | Rehabilitation Practitioner | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2018-01-23 |
| 1013424928 | Tal Medovoy | Rehabilitation Practitioner | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2018-01-02 |
| 1477069771 | Naomi Choi | Marriage & Family Therapist | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-12-21 |
| 1861908436 | Abel Torres | Marriage & Family Therapist | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-12-19 |
| 1134633431 | Christopher Monroy | Rehabilitation Practitioner | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-11-22 |
| 1255845897 | Tatiana Ewing | Marriage & Family Therapist | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-11-17 |
| 1619480662 | Stephanie Bobadilla | Social Worker | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-11-13 |
| 1982117198 | Vickie Joan Wagner | Marriage & Family Therapist | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-11-09 |
| 1225540271 | Mariah Gabriella Dillard | Marriage & Family Therapist | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619451697 | Tonya Michlin | Registered Nurse | 800 Fairmount Ave Ste 110, Pasadena, CA 91105 | 2018-09-17 |
| 1639674161 | David Marcus Md, Inc. | Psychiatry & Neurology | 107 S. Fair Oaks Avenue, Suite #315, Pasadena, CA 91105 | 2018-03-27 |
| 1548778541 | Elias & Jun Dental Corp | Dentist | 301 S. Fair Oaks Ave., Ste 107, Pasadena, CA 91105 | 2018-01-12 |
| 1013429745 | Whitney Catalano | Dietitian, Registered | 100 S Orange Grove Blvd, 103, Pasadena, CA 91105 | 2017-11-03 |
| 1518485630 | Marlon O Miller | Counselor | 1020 South Arroyo Parkway, Pasadena, CA 91105 | 2017-09-08 |
| 1316469976 | Alexandra Scott | Speech-Language Pathologist | 235 La Vereda Road, Pasadena, CA 91105 | 2017-07-14 |
| 1346770443 | Amanda Grace Gentz | Rehabilitation Practitioner | 210 S De Lacey, Ste 110, Pasadena, CA 91105 | 2017-06-13 |
| 1427598390 | Melina Gomez Loza | Licensed Vocational Nurse | 66 Hilburt St #2, Pasadena, CA 91105 | 2017-02-27 |
| 1588115281 | Ramon Banuelos | Rehabilitation Practitioner | 210 S. Delacey Ave Suite 110, Pasadena, CA 91105 | 2016-10-18 |
| 1922554245 | Daniel Joseph Ybarra | Student in an Organized Health Care Education/Training Program | 100 W. California Blvd. Pasadena, Ca 91105, Pasadena, CA 91105 | 2016-08-28 |
| Find all providers in zip 91105 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780230441 | Dr. Matthew Calkins, Psy.d., A Psychological Corporation | Psychologist | 595 E Colorado Blvd Ste 335, Pasadena, CA 91101-2060 | 2019-08-17 |
| 1568022648 | Mindfull Neuropsychology and Psychology | Psychologist | 3838 E Foothill Blvd, Pasadena, CA 91107-2203 | 2019-06-19 |
| 1528533924 | Nina Huong Nguyen | Psychologist | 595 E Colorado Blvd Ste 802, Pasadena, CA 91101-2001 | 2018-10-11 |
| 1598288359 | Steven I Brawer Phd Clinical Psychologist Inc | Psychologist | 766 E Colorado Blvd Ste 203, Pasadena, CA 91101-5421 | 2017-07-24 |
| 1225575293 | Catherine Lynn Gray | Psychologist | 30 North Raymond Avenue, Suite 403, Pasadena, CA 91103 | 2017-01-27 |
| 1700320223 | Jenny H. Pak | Psychologist | 180 N. Oakland Ave., Pasadena, CA 91101 | 2016-12-19 |
| 1396192282 | Angel Duncan | Psychologist | 745 S Marengo Ave Ste 200, Pasadena, CA 91106-4738 | 2016-05-20 |
| 1568847697 | James Bernhardt | Psychologist | 2330 E Del Mar Blvd, Apt. 117, Pasadena, CA 91107-4718 | 2015-07-30 |
| 1043691975 | Deborah Liddi Brown | Psychologist | 446 S Marengo Ave Ste B, Pasadena, CA 91101-3113 | 2015-06-16 |
| 1144627878 | The Arroyos Psychological Associates, Inc. | Psychologist | 1 West California Boulevard, Pasadena, CA 91105 | 2014-11-24 |
| Find all providers in PASADENA | ||||
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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.