Provider Demographics
NPI:1831517309
Name:PHAM, HUONG XUAN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HUONG
Middle Name:XUAN
Last Name:PHAM
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14362 MORAN ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5144
Mailing Address - Country:US
Mailing Address - Phone:714-488-4845
Mailing Address - Fax:
Practice Address - Street 1:14362 MORAN ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5144
Practice Address - Country:US
Practice Address - Phone:714-488-4845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 21211235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist