JACQUELINE PHAM
NPI 1114534542
Nurse Practitioner - Psychiatric/Mental Health in Mission Viejo, CA
About Jacqueline Pham NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACQUELINE PHAM (NPI 1114534542) is an individual psychiatric/mental health provider in Mission Viejo, California, licensed in California (95011232) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Newport Beach.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jacqueline Pham is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jacqueline Pham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fremont, CA 94538
- Reassigned Medicare billing, California enrollment
- 31 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92692 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MISSION VIEJO, CA 92692
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacqueline Pham's NPI number?
The NPI number for Jacqueline Pham is 1114534542. It was assigned to this individual provider in the NPPES registry on September 29, 2020.
Where is Jacqueline Pham located?
Jacqueline Pham practices at 25272 Marguerite Pkwy, Mission Viejo, CA 92692. The listed phone number is (949) 581-9120.
What is Jacqueline Pham's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Jacqueline Pham enrolled in Medicare?
Yes. Jacqueline Pham is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jacqueline Pham's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Pham reassigns Medicare benefits to Ocean Psychiatry Inc (Fremont, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Pham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jacqueline Pham was last updated on October 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jacqueline Pham · NPI 1114534542
Psychiatric/Mental Health physician in Mission Viejo, California. Individual provider, active in the CMS NPPES registry since September 29, 2020.
## Identity
- **NPI:** 1114534542 (Entity type: Individual)
- **Enumerated:** September 29, 2020
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 95011232 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 25272 MARGUERITE PKWY, Mission Viejo, CA 92692-2901
- **Phone:** (949) 581-9120
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Ocean Psychiatry Inc (NPI 1396306338, Fremont, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 14, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1114534542) · Data from the CMS NPPES public registry.