Most Relevant Information
Provider Data
| NPI Number: | 1003269051 |
| Provider Name: | CORRINE THANH NGOC PHAN LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 83594 |
Most Important Dates
| Enumeration Date: | 07/14/2016 |
| Last Updated: | 10/21/2021 |
Provider Practice Location
995 GATEWAY CENTER WAY
SUITE 300
SAN DIEGO
CA
921024500
Practice Location Phone/Fax
| Phone: | 6193982156 |
| Fax: | 6193982168 |
Provider Mailing Location
995 GATEWAY CENTER WAY
SUITE 300
SAN DIEGO
CA
92102
Provider Mailing Phone/Fax
| Phone: | 6193982156 |
| Fax: | 6193982168 |