Individual provider · Type 1 NPI

Phuong Daole Pham, PMHNP

Psychiatric/Mental Health Nurse Practitioner · San Diego, CA

NPI number 1700200664 Active

Practice location

15373 Innovation Dr Ste 390
San Diego, CA 92128-3429

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XNP95019215 (CA)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1700200664

Phuong Daole Pham, PMHNP's National Provider Identifier is 1700200664, issued on Feb 13, 2014. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in San Diego, CA. The record was last updated on May 1, 2026.