Provider Demographics
NPI:1932667375
Name:LE, HONGMY PHAM (BS)
Entity Type:Individual
Prefix:MISS
First Name:HONGMY
Middle Name:PHAM
Last Name:LE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 W BALL RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3807
Mailing Address - Country:US
Mailing Address - Phone:714-757-3758
Mailing Address - Fax:
Practice Address - Street 1:12062 VALLEY VIEW ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-1737
Practice Address - Country:US
Practice Address - Phone:562-356-8600
Practice Address - Fax:562-356-8600
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician