Dr Priscilla Phan, PSYD is a
Psychologist - Clinical based in Cannon Afb, New Mexico. Dr Priscilla Phan is licensed to practice in Virginia (license number 0810008963) and her current practice location is
224 W D.l. Ingram Ave, Bldg. 1408, Cannon Afb, New Mexico. She can be reached at her office (for appointments etc.) via phone at
(575) 784-1108.
NPI number for Dr Priscilla Phan is 1699412171 and her current mailing address is 27 Somdg, 104 W. D.l. Ingram Ave, Cannon Afb, New Mexico. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1699412171.
Healthcare Provider's Profile
Full Name | Dr Priscilla Phan |
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Gender | Female |
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Speciality | Psychologist - Clinical |
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Location | 224 W D.l. Ingram Ave, Cannon Afb, New Mexico |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1699412171
- Provider Enumeration Date: 05/17/2022
- Last Update Date: 06/27/2025
Medical Identifiers
Medical identifiers for Dr Priscilla Phan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699412171 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (New Mexico) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (Texas) | Secondary |
103TC0700X | Psychologist - Clinical | 0810008963 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Priscilla Phan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Priscilla Phan, PSYD 27 Somdg, 104 W. D.l. Ingram Ave, Cannon Afb, NM 88101 Ph: (575) 784-1108 | Dr Priscilla Phan, PSYD 224 W D.l. Ingram Ave, Bldg. 1408, Cannon Afb, NM 88103 Ph: (575) 784-1108 |
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