PETERSON Q PHAM (NPI# 1790107597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790107597 |
| Entity Type | Individual |
| Full Name | PETERSON Q PHAM |
| Credential | ASW |
| Practice Address |
12912 Brookhurst St Ste 480 Garden Grove CA 92840-4867 |
| Mailing Address |
Po Box 1789 Garden Grove CA 92842-1789 |
| Practice Telephone | 7146366286 |
| Practice Fax Number | 7146368354 |
| Mailing Telephone | 6572060035 |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2018-11-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BOARD OF BEHAVIORAL SCIENCES | ASW85404 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1200 N Main St, 100b, Santa Ana, CA 927013640 | 7144806661 |
| Street Address |
12912 BROOKHURST ST STE 480 |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92840-4867 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215290622 | Bao Gia Le | Marriage & Family Therapist | 12912 Brookhurst St Ste 480, Garden Grove, CA 92840-4867 | 2012-06-20 |
| 1033725981 | Taiyee Vue | Counselor | 12912 Brookhurst St Ste 480, Garden Grove, CA 92840-4867 | 2020-09-16 |
| 1407460991 | Weiting Tiffany Chen | Counselor | 12912 Brookhurst St Ste 480, Garden Grove, CA 92840-4867 | 2020-09-02 |
| 1770109902 | Sharon Hsiang-hsuen Hou | Marriage & Family Therapist | 12912 Brookhurst St Ste 480, Garden Grove, CA 92840-4867 | 2020-06-23 |
| 1790300622 | Emily Kim | Counselor | 12912 Brookhurst St Ste 480, Garden Grove, CA 92840-4867 | 2020-06-16 |
| 1073132700 | Phuong Nguyen | Counselor | 12912 Brookhurst St Ste 480, Garden Grove, CA 92840-4867 | 2020-04-13 |
| 1184257099 | Trang Ngoc Thuy Nguyen | Counselor | 12912 Brookhurst St Ste 480, Garden Grove, CA 92840-4867 | 2020-02-19 |
| 1548892748 | Wei-shan Chang | Marriage & Family Therapist | 12912 Brookhurst St Ste 480, Garden Grove, CA 92840-4867 | 2020-02-06 |
| 1003453994 | Lynn Shim | Counselor | 12912 Brookhurst St Ste 480, Garden Grove, CA 92840-4867 | 2019-12-10 |
| 1851935514 | Chau Minh Nguyen | Counselor | 12912 Brookhurst St Ste 480, Garden Grove, CA 92840-4867 | 2019-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283808 | Kimberly Gaeta | Behavioral Analyst | 123935 Lewis Street, Ste 202, Garden Grove, CA 92840 | 2020-04-16 |
| 1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
| 1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
| 1346730116 | Vinh Le Tran | Pharmacist | 12666 Brookhurst St. Suite 110, Garden Grove, CA 92840 | 2018-05-16 |
| 1841715232 | Scott R. Blair | Physician Assistant | 12828 Harbor Blvd Ste 200, Garden Grove, CA 92840 | 2017-08-07 |
| 1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
| 1548688732 | House Call Medical Associates, Inc. | Internal Medicine | 12865 Main St Ste 105, Garden Grove, CA 92840 | 2014-04-03 |
| 1851733059 | Carly Ann Wade | Marriage & Family Therapist | 12755 Brookhurst St. Ste 116, Garden Grove, CA 92840 | 2013-07-29 |
| 1003159864 | Priyal Shah Ohri | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840 | 2013-03-30 |
| 1770853244 | Joseph Pham | Pharmacist | 12001 Euclid St., Garden Grove, CA 92840 | 2011-12-30 |
| Find all providers in zip 92840 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144673211 | Karina Arcos | Social Worker | 12631 Lewis St Apt 39, Garden Grove, CA 92840-6210 | 2016-07-13 |
| 1760715783 | Lorraine Fiaavae Tuala | Social Worker | 12900 Garden Grove Blvd Ste A214, Garden Grove, CA 92843-2026 | 2009-09-09 |
| 1982837167 | Ye Lee | Social Worker | 12900 Garden Grove Blvd., Suite 214a, Garden Grove, CA 92843 | 2009-09-03 |
| 1114176781 | Michelle Mai Nguyen | Social Worker | 12900 Garden Grove Blvd Ste 214a, Garden Grove, CA 92843-2006 | 2008-09-18 |
| 1821120460 | Mary Vu | Social Worker | 12900 Garden Grove Blvd Ste 214 A, Garden Grove, CA 92843-2006 | 2007-03-09 |
| 1164908471 | Erika Aranda | Social Worker | 7441 Lincoln Way Ste 250, Garden Grove, CA 92841-1452 | 2018-07-19 |
| 1982072930 | Deborah Hong | Social Worker | 12900 Garden Grove Blvd, Ste A214, Garden Grove, CA 92843-2006 | 2015-09-08 |
| 1578986279 | Eric Burnell | Social Worker | 7281 Garden Grove Blvd, Garden Grove, CA 92841-4212 | 2014-01-31 |
| 1912332065 | Adam Archiable | Social Worker | 12755 Brookhurst St, Suite # 116, Garden Grove, CA 92840-4857 | 2013-09-09 |
| 1306279765 | Dao Duy Truong | Social Worker | 9862 Chapman Ave Ste B, Garden Grove, CA 92841-2726 | 2013-08-20 |
| Find all providers in GARDEN GROVE | ||||
| City | GARDEN GROVE |
| Zip Code | 92840 |
Please comment or provide details below to improve the information on PETERSON Q PHAM.
| 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.