PHONG LAM (NPI# 1770034696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770034696 |
| Entity Type | Individual |
| Full Name | PHONG LAM |
| Practice Address |
1340 Tully Rd Ste 304 San Jose CA 95122-3055 |
| Mailing Address |
1764 Arroyo De Oro San Jose CA 95116-1349 |
| Practice Telephone | 4082713900 |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
1340 TULLY RD STE 304 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95122-3055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326176116 | James Peter Keim | Social Worker | 1340 Tully Rd Ste 304, San Jose, CA 95122-3055 | 2007-03-01 |
| 1720695711 | Jazmin Marie Salazar | Counselor | 1340 Tully Rd Ste 304, San Jose, CA 95122-3055 | 2020-09-24 |
| 1760098925 | Boshan Zhao | Counselor | 1340 Tully Rd Ste 304, San Jose, CA 95122-3055 | 2020-09-22 |
| 1316553951 | Berneise Billote Montuya | Peer Specialist | 1340 Tully Rd Ste 304, San Jose, CA 95122-3055 | 2020-09-18 |
| 1477169191 | Silvia Vanessa Cortes Ramirez | Student in an Organized Health Care Education/Training Program | 1340 Tully Rd Ste 304, San Jose, CA 95122-3055 | 2020-09-17 |
| 1851907562 | Lani Ngoc Hoang | Counselor | 1340 Tully Rd Ste 304, San Jose, CA 95122-3055 | 2020-09-17 |
| 1265060651 | Perry Partlow | Case Manager/Care Coordinator | 1340 Tully Rd Ste 304, San Jose, CA 95122-3055 | 2020-03-31 |
| 1689223109 | Christine Nguyen | Student in an Organized Health Care Education/Training Program | 1340 Tully Rd Ste 304, San Jose, CA 95122-3055 | 2019-09-06 |
| 1205397106 | Nguon Doan Nguyen | Specialist | 1340 Tully Rd Ste 304, San Jose, CA 95122-3055 | 2019-03-26 |
| 1730662339 | Alyson Le | Student in an Organized Health Care Education/Training Program | 1340 Tully Rd Ste 304, San Jose, CA 95122-3055 | 2018-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437788015 | Vietnam Pharmacy Inc | Pharmacy | 2451 S King Rd Suite A1, San Jose, CA 95122 | 2020-04-06 |
| 1346894524 | Amy Le Tran | Counselor | Mekong Community Center, 2203 Tully Road, San Jose, CA 95122 | 2019-07-26 |
| 1164980439 | Tri Starr Home Care, LLC | PACE Provider Organization | 1609 Flanigan Dr., Unit H, Unit H, San Jose, CA 95122 | 2019-03-06 |
| 1740761196 | Aileen Phu | Acupuncturist | 1271 Story Rd Ste 50, San Jose, CA 95122 | 2018-08-23 |
| 1740775816 | Urgent Care Clinic of Northern Ca Inc | Clinic/Center | 999 Story Road, Suite 9021, San Jose, CA 95122 | 2018-06-29 |
| 1952825911 | Robert Martin Thomas | Counselor | 950 Julian St, San Jose, CA 95122 | 2017-08-01 |
| 1497113153 | Jamealle Spain | Case Manager/Care Coordinator | 2070 Lucretia Ave #310, San Jose, CA 95122 | 2016-02-09 |
| 1770915035 | Thinh Tran | Dentist | 919 Story Rd Unit 1128, San Jose, CA 95122 | 2013-08-08 |
| 1356591333 | Asian American Recovery Services | Counselor | 1340 Tully Rd., San Jose, CA 95122 | 2008-09-25 |
| 1821246505 | Samara Rachel Stone | Marriage & Family Therapist | 1340 Tully Road, Suite 304, San Jose, CA 95122 | 2008-09-05 |
| Find all providers in zip 95122 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104451194 | Arthur Warren Hall | Counselor | 298 A Bernal Road, San Jose, CA 95119 | 2020-03-10 |
| 1609412469 | Cathy Logie | Counselor | 2682 Coit Dr, San Jose, CA 95124-1611 | 2019-11-26 |
| 1831692722 | Nicholas Jordon Thompson | Counselor | 2218 North First Street, San Jose, CA 95131 | 2018-03-16 |
| 1376045591 | Michael Li | Counselor | 2202 N 1st St, San Jose, CA 95131-2007 | 2018-03-03 |
| 1104338805 | Sydney Louise Tai | Counselor | 1370 Tully Rd Ste 301, San Jose, CA 95122-3056 | 2017-11-02 |
| 1932624871 | Linh Tuyet Vong | Counselor | 760 Pelleas Ln, San Jose, CA 95127-1030 | 2017-08-12 |
| 1760907273 | Marina Marie Mendonca | Counselor | 650 S. Bascom Ave, San Jose, CA 95128 | 2017-08-04 |
| 1952825911 | Robert Martin Thomas | Counselor | 950 Julian St, San Jose, CA 95122 | 2017-08-01 |
| 1386171221 | Mia Yvone Jaurigue | Counselor | 151 W Mission St # A1, San Jose, CA 95110-1713 | 2017-05-22 |
| 1396296307 | Andres Lujan Jr. | Counselor | 1867 Senter Rd, San Jose, CA 95112-2527 | 2016-10-14 |
| Find all providers in SAN JOSE | ||||
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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.