Priscilla Phan, PSYD
NPI 1699412171ActiveIndividual· Psychologist, Clinical· Cannon Afb, NM
Psychologist, Clinical (PSYD) in Cannon Afb, New Mexico, licensed in VA, with an NPI issued in May 2022.
Overview
| NPI | 1699412171 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD |
| Sole proprietor | No |
| NPI issued | May 17, 2022 |
| Last updated in NPPES | Jun 27, 2025 |
| Certified by provider | Jun 27, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 0810008963 | VA |
| Counselor, Mental Health | 101YM0800X | — | NM |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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