TRACY PHAN (NPI# 1972137446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972137446 |
| Entity Type | Individual |
| Full Name | TRACY PHAN |
| Credential | NP |
| Practice Address |
969 Story Rd Unit 6060a San Jose CA 95122-4601 |
| Mailing Address |
1569 Lexann Ave Ste 114 San Jose CA 95121-1794 |
| Practice Telephone | 4082238818 |
| Mailing Telephone | 4086801940 |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2020-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP95013765 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619592987 | Tracy Thuy Phan | Family Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-12 |
| 1558761676 | Tracy Phan | Pharmacist | 17835 Gale Ave, City of Industry, CA 91748-1526 | 2014-08-26 |
| 1780968487 | Tracy Elizabeth Phan | Pharmacist | 2500 Alhambra Ave, Martinez, CA 94553-3156 | 2011-09-30 |
| 1659688638 | Tracy Huyen Tram Phan | Pharmacist | 4300 Elverta Rd, Antelope, CA 95843-6700 | 2010-09-11 |
| Street Address |
969 STORY RD UNIT 6060A |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95122-4601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275514069 | Thang Duc Tran | Internal Medicine | 969 Story Rd Unit 6060a, San Jose, CA 95122-4601 | 2005-11-08 |
| 1568004257 | Valerie Le | Internal Medicine | 969 Story Rd Unit 6060a, San Jose, CA 95122-4601 | 2019-10-14 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565738 | Lena Kil | Nurse Practitioner | 3680 Greenlee Dr Apt 4, San Jose, CA 95117-1469 | 2020-10-09 |
| 1740893858 | Esther Kiang | Nurse Practitioner | 1072 E Santa Clara St, San Jose, CA 95116-2245 | 2020-08-28 |
| 1902419575 | Leonard Iskander | Nurse Practitioner | 1146 Summerpark Ct, San Jose, CA 95132-2944 | 2020-08-25 |
| 1760004055 | Destiny Ann Brewer | Nurse Practitioner | 4735 Hamilton Ave # 80, San Jose, CA 95130-1769 | 2020-05-11 |
| 1841825148 | Marta Anna Sivarajah | Nurse Practitioner | 255 N. White Rd., San Jose, CA 95127-1966 | 2020-03-06 |
| 1114567500 | Sabine Dorothea Haas | Nurse Practitioner | 1879 Lundy Ave Ste 233, San Jose, CA 95131-1881 | 2020-01-14 |
| 1861033870 | Jessica Gutierrez | Nurse Practitioner | 635 S 11th St Apt 14, San Jose, CA 95112-2343 | 2019-10-01 |
| 1124589379 | Yvonne Ndeh | Nurse Practitioner | 418 Shadowgraph Dr, San Jose, CA 95110-3564 | 2019-03-29 |
| 1588139661 | Vicky Chi Lin | Nurse Practitioner | 100 Oak St Rm F-3, San Jose, CA 95110-2817 | 2018-10-04 |
| 1851884381 | Anh Tuan Huynh | Nurse Practitioner | 3100 Rubino Dr Apt 310, San Jose, CA 95125-6369 | 2018-06-09 |
| 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.