Provider Demographics
NPI:1649529819
Name:DO, THUY-PHUONG (PSYD)
Entity type:Individual
Prefix:
First Name:THUY-PHUONG
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 SHELTER ISLAND DR # 365
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2731
Mailing Address - Country:US
Mailing Address - Phone:619-609-7722
Mailing Address - Fax:858-221-8565
Practice Address - Street 1:2726 SHELTER ISLAND DR # 365
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-2731
Practice Address - Country:US
Practice Address - Phone:619-609-7722
Practice Address - Fax:858-221-8565
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAPSY31042101YM0800X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health