Individual ProviderTina-Vanthi Thi PhamCounselorBehavioral Health & Social Service ProvidersPractice Address934 N Mountain Ave Ste C, Upland, CA 91786-3659(909) 579-8100PECOS EnrollmentBased on the most recent information from CMS, provider Tina-Vanthi Thi Pham does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1225171242Provider TypeIndividualFull NamePham, Tina-Vanthi ThiGenderFemaleSole ProprietorNoEnumeration Date2/15/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address934 N Mountain Ave Ste C, Upland, CA 91786-3659Phone(909) 579-8100Fax(909) 579-8149Mailing LocationMailing Address934 N Mountain Ave Ste C, Upland, CA 91786-3659Phone(909) 579-8100Fax(909) 579-8149Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer