Provider Demographics
NPI:1295076032
Name:PHUNG, SOIKIEU
Entity type:Individual
Prefix:
First Name:SOIKIEU
Middle Name:
Last Name:PHUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUNNI
Other - Middle Name:SOIKIEU
Other - Last Name:PHUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10418 VALLEY BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-3600
Mailing Address - Country:US
Mailing Address - Phone:626-258-1600
Mailing Address - Fax:626-258-1609
Practice Address - Street 1:10418 VALLEY BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3600
Practice Address - Country:US
Practice Address - Phone:626-258-1600
Practice Address - Fax:626-258-1609
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker