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

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1700200664

Phuong Daole Pham, PMHNP is a Nurse Practitioner in San Diego, California. Qualified in 2021, 5 years ago. Practices with Mark David Levine MD Professional Corporation, a 157-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2014
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

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Practice location Address checks out

15373 Innovation Dr Ste 390
San Diego, CA 92128-3429
Phone: (855) 501-1004
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence NP95019215 (CA)

Record details

NPI number1700200664
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP
Sole proprietorNo
NPI enumeratedFebruary 13, 2014
Last updated in NPPESMay 1, 2026
Certification dateMay 1, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Mark David Levine Md Professional Corporation — 157 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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