| Doctor Name: | MRS. DIEM HONG PHAN |
| NPI Number: | 1104955939 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BS |
| License Number: | |
| Business Practice Address: | 9353 Valley Blvd Rosemead, CA - 917701934 |
| Business Phone Number: | 6262872988 |
| Business Fax Number: | |
| Mailing Address: | 1957 Gemini St, WEST COVINA |
| State: | CA |
| Postal Code: | 917922307 |
| Phone Number: | 6268312223 |
| Fax Number: | |
| NPI Enumeration Date: | 03/05/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |