Provider Demographics
NPI:1730835497
Name:PHAM, TAM-ANH (MA, LMFT)
Entity type:Individual
Prefix:
First Name:TAM-ANH
Middle Name:
Last Name:PHAM
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 E. CAMPBELL AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2001
Mailing Address - Country:US
Mailing Address - Phone:408-345-2323
Mailing Address - Fax:408-370-6196
Practice Address - Street 1:51 E. CAMPBELL AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2001
Practice Address - Country:US
Practice Address - Phone:408-345-2323
Practice Address - Fax:408-370-6196
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36949106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist