Individual
CORRINE THANH NGOC PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
995 GATEWAY CENTER WAY, SUITE 300, SAN DIEGO, CA 92102-4500
(619) 398-2156
(619) 398-2168
Mailing address
995 GATEWAY CENTER WAY, SUITE 300, SAN DIEGO, CA 92102
(619) 398-2156
(619) 398-2168
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
83594
CA
104100000X
Social Worker
Primary
100441
CA
Other
Enumeration date
07/14/2016
Last updated
10/21/2021
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