Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacklynne Phan

Individual provider Physician Assistant · NPI 1649904210

Jacklynne Phan is a Physician Assistant in San Diego, California. Graduated from University of Southern California Keck School of Medicine in 2024, 2 years ago. Practices with Sunset ENT Inc, a 4-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA
In the registry since
2022
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Practice location Address checks out

4282 Genesee Ave Ste 201
San Diego, CA 92117-4964
Phone: (858) 746-7882
Fax: (858) 505-1918
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA6777 (CA)

Record details

NPI number1649904210
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 11, 2022
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2024 (2 years in practice)
Group practice Sunset Ent Inc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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