Provider Demographics
NPI:1912680810
Name:PHAN, CLAIRE HONG AN (DPT)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:HONG AN
Last Name:PHAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 DUCHESS CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-2012
Mailing Address - Country:US
Mailing Address - Phone:408-518-1594
Mailing Address - Fax:
Practice Address - Street 1:1716 MIRAMONTE AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3763
Practice Address - Country:US
Practice Address - Phone:650-934-0455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist