JENNIFER PHAM


Address: 2250 S Main St, Ste. 104, Corona, CA 92882-2534
Phone: 9517371454

JENNIFER PHAM (NPI# 1396993713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396993713
Entity Type Individual
Full Name JENNIFER PHAM
Credential P.A
Practice Address 2250 S Main St
Ste. 104
Corona
CA 92882-2534
Mailing Address 1901 Town and Country Dr
Ste 104
Norco
CA 92860-3611
Practice Telephone 9517371454
Mailing Telephone 9518086240
Mailing Fax Number 9517389954
Enumeration Date 2008-08-28
Last Update Date 2019-03-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
Physician Assistants & Advanced Practice Nursing Providers

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1972101186 Jennifer Pham Pharmacist 1411 E 31st St, Oakland, CA 94602-1018 2020-10-12
1871110205 Jennifer Pham Behavior Technician 1401 E 7th St, Charlotte, NC 28204-6300 2020-07-01
1437784717 Jennifer Pham Optometrist 8520 N Beach St, Fort Worth, TX 76244-4918 2020-03-07
1235629932 Jennifer Pham Student in an Organized Health Care Education/Training Program 1514 Jefferson Hwy, Jefferson, LA 70121-2429 2018-05-17
1720505498 Jennifer Pham Pharmacist 565 W 235th St, Bronx, NY 10463-1650 2017-08-24
1457880569 Jennifer Pham Dentist 1300 N Ventura Rd Ste 2, Oxnard, CA 93030 2017-06-12

Office Location

Street Address 2250 S MAIN ST
STE. 104
City CORONA
State CA
Zip Code 92882-2534

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457343022 Anthony John Pirritano Chiropractor 2250 S Main St, Ste 203, Corona, CA 92882-2534 2005-08-18
1518414515 Sarah Nelson Nurse Practitioner 2250 S Main St, Ste. 106, Corona, CA 92882-2534 2016-09-07
1205289956 Mission Surgical Group Clinic/Center 2250 S Main St, Suite 206, Corona, CA 92882-2534 2016-07-18
1477923845 Bluechip Infusion Services Home Infusion 2250 S Main St, Suite 106, Corona, CA 92882-2534 2015-09-29
1023400322 Integrated Medical Center of Corona Inc. Clinic/Center 2250 S Main St, Suite 203, Corona, CA 92882-2534 2015-02-23
1235362203 Sarah Santos Chiropractor 2250 S Main St, #203, Corona, CA 92882-2534 2009-08-25
1891938155 Circle City Ekg Reading Panel,inc Specialist 2250 S Main St, Ste 201, Corona, CA 92882-2536 2009-04-15
1316108491 Srinidhi Ekkati Physician Assistant 2250 S Main St, Suite 201, Corona, CA 92882-2534 2008-06-20
1194903344 Tracey Doxzon Physician Assistant 2250 S Main St, Ste 106, Corona, CA 92882-2534 2008-02-08
1184802332 Nicole Rae Newman Physician Assistant 2250 S Main St, Ste. 106, Corona, CA 92882-2534 2008-02-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477116341 People Providing Training Solutions Health Educator 650 S. Main Street Corona Public Library, Corona, CA 92882 2019-04-17
1972080752 Boris Shlopov Md Pathology Medical Corporation Pathology 800 S Main, Corona, CA 92882 2018-07-24
1316431232 Julia's Care Hospice Hospice Care, Community Based 1450 N Sixth St, Ste 117, Corona, CA 92882 2018-06-15
1477060499 Shilpy Kanda Physician Assistant 2250 S Main St Ste 107, Corona, CA 92882 2017-12-29
1831616333 Cindy Ruiz Behavioral Analyst 2868 Briarhaven Ln, Corona, CA 92882 2017-08-24
1366965667 3 Vest Medical Transportation Wc LLC Non-emergency Medical Transport (VAN) 3256 Rural Lane, Corona, CA 92882 2017-07-19
1477073468 Adrian Macias I Counselor 2275 South Main Street Suite 201 Corona, Ca 92882, Corona, CA 92882 2017-06-21
1699205286 Sylvia Barrow Counselor 2275 South Main Street Suite 201, Corona, CA 92882 2017-06-15
1417348574 Pensar Medical Durable Medical Equipment & Medical Supplies 1269 Pomona Rd Ste 107, Corona, CA 92882 2015-02-11
1215327085 Anne Maureen Sims Social Worker 2275 South Main, #201, Corona, CA 92882 2015-01-30
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043677859 Erika Crystal Reyes Physician Assistant 127 N Mckinley St Ste 101, Corona, CA 92879-6563 2016-01-25
1255710240 Griselle Villar Ledesma Physician Assistant 10427 Corona Ave, Corona, NY 11368-2979 2015-05-22
1558668772 Jenna Lalas Eugenio Physician Assistant 2097 Compton Ave Ste 103, Corona, CA 92881 2011-02-24
1457660359 Rudy Manuel Ramirez Physician Assistant 13355 Green Mountain Dr, Corona, CA 92883-6229 2010-09-27
1720311012 Hugh Kling Berkley Physician Assistant 760 Washburn Ave Ste 5/6, Corona, CA 92882-3303 2009-09-17
1740420918 Sean David Totten Physician Assistant 1492 Fairmont Dr, Corona, CA 92882 2009-03-02
1477745768 Rose M Ruiz-flores Physician Assistant 1530 W 6th St Ste 109, Corona, CA 92882-2784 2007-08-10
1902097926 Lansdale John Peters Physician Assistant 1231 Kendrick Ct, Corona, CA 92881-8226 2007-08-06
1891865747 Phuong Anh Thi La Physician Assistant 2071 Compton Ave, Suite 102, Corona, CA 92881-7278 2006-11-08
1366525461 Carina Julie-ann Moscoso Physician Assistant 2250 S. Main St., Suite 201, Corona, CA 92882-2536 2006-10-23
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Competitor

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City CORONA
Zip Code 92882

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Dataset Information

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.

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