1. Home
  2. Directory
  3. New Mexico
  4. Cannon Afb
  5. Psychologist
  6. NPI Profile

DR. PRISCILLA PHAN PSYD
NPI 1699412171
Psychologist - Clinical in Cannon Afb, NM

Active since May 17, 2022
224 W D.L. INGRAM AVE, BLDG. 1408, CANNON AFB, NM 88103(575) 784-1108 Get Directions Write a Review

NPPES record last updated: June 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 27, 2025, Sep 22, 2022, May 17, 2022 (3 updates tracked since 2022).

About Dr. Priscilla Phan Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PRISCILLA PHAN PSYD (NPI 1699412171) is an individual clinical provider in Cannon Afb, New Mexico, licensed in Virginia (0810008963) and active in the NPI registry since May 2022.

NPPES Registry Identity

NPI1699412171
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. PRISCILLA PHANCredential: PSYD
Location Address224 W D.L. INGRAM AVE, BLDG. 1408Cannon Afb, NM 88103
Mailing Address27 Somdg, 104 W. D.l. Ingram AveCannon Afb, NM 88101 · (575) 784-1108
Phone(575) 784-1108
Sole ProprietorNo
Enumeration DateMay 17, 2022
Last NPPES UpdateJune 27, 20253 updates tracked since enumeration
NPPES CertifiedJune 27, 2025
✔ NPI 1699412171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in VA · 0810008963
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
224 W D.L. INGRAM AVE, Cannon Afb, NM 88103
Open in Google Maps ↗

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANTHONY ZIZZO
Behavior Technician
224 W D.L. INGRAM AVE
CANNON AIR FORCE BASE, NM 88103
Curry County (575) 784-1108
ALEXA SHAE PEREZ
Behavior Technician
224 W D.L. INGRAM AVE
CANNON AIR FORCE BASE, NM 88103
Curry County (575) 904-3616
NICHOLAS Y EISENBERG MD
Internal Medicine
224 W D.L. INGRAM AVE, BLDG 1408
CANNON AFB, NM 88103
Curry County (575) 681-3917

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 Priscilla Phan's NPI number?

The NPI number for Priscilla Phan is 1699412171. It was assigned to this individual provider in the NPPES registry on May 17, 2022.

Where is Priscilla Phan located?

Priscilla Phan practices at 224 W D.L. Ingram Ave Bldg. 1408, Cannon Afb, NM 88103. The listed phone number is (575) 784-1108.

What is Priscilla Phan's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Priscilla Phan was last updated on June 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.