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

Mrs. Michelle Theresa Petrillo Phan

Individual provider Behavior Analyst · NPI 1033824974

Mrs. Michelle Theresa Petrillo Phan is a Behavior Analyst in Newport Beach, California. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1151 Dove St
Newport Beach, CA 92660-2840
Phone: (949) 630-8290
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X

Record details

NPI number1033824974
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 16, 2023
Last updated in NPPESSeptember 11, 2025
Certification dateJanuary 15, 2023

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