Individual provider · Type 1 NPI

Phung Phan

Mental Health Counselor · San Mateo, CA

NPI number 1770916413 Active

Practice location

2600 S El Camino Real
San Mateo, CA 94403-2380

Fax (408) 347-3121

Mailing address

3009 Wall St
San Jose, CA 95111-4601

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1770916413

Phung Phan's National Provider Identifier is 1770916413, issued on Aug 16, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Mateo, CA. The record was last updated on Aug 4, 2015.