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Thanh Phuong Le

Social Worker

Behavioral Health & Social Service Providers

2401 Merced St, San Leandro, CA 94577-4228

PECOS Enrollment

This provider is enrolled in PECOS as THANH LE.

Based on the most recent information from CMS, provider Thanh Phuong Le is legally eligible to order and refer claims for DME services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1114206729
Provider Type
Individual
Full Name
Le, Thanh Phuong
Title
Miss
Credential
LCSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
8/12/2011
Last Updated
2/11/2022

Contact Information

Practice Location

2401 Merced St, San Leandro, CA 94577-4228

(510) 618-5969

(510) 618-5830

Mailing Location

1136 Gassett Ct, Hayward, CA 94544-5753

(510) 309-0417

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 87307 California
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Thanh Phuong Le

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Perry, Ellen Elizabeth

Williams, Valerie Anne

Grimm, Norma P.

Shah, Kalyani Kalpen

Stewart, Tatiana Geneva

Nickelson, Kalene

Clarke, Tayler Michelle

Fujii, Sarah

Cabrera Munoz, Diana Elizabeth

Dacoste, Marcy John