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Organization

Mydung Phan

NPI Record: ActivePeer Specialist
NPI1083429369
Glendale, Arizona

Provider's NPPES record last updated: February 16, 2025

Overview

Entity Type
Organization
NPI
1083429369
Primary Specialty
Peer Specialist
Practice Location
Glendale, Arizona
Organization Subpart
Yes
Parent Organization
Radadvantage a Professional Corporation

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 19, 2026, 8:34 AM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Peer Specialist

    Other Service Providers

    Primary

    Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

    Taxonomy code 175T00000X
  • Nutritionist

    Dietary & Nutritional Service Providers

    A specialist in adapting and applying food and nutrient knowledge to the solution of food and nutritional problems, the control of disease, and the promotion of health. Nutritionists perform research, instruct groups and individuals about nutritional requirements, and assist people in developing meal patterns that meet their nutritional needs; (2) A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation.

    Taxonomy code 133N00000X
  • Dietitian, Registered

    Nutrition, Obesity and Weight Management

    Dietary & Nutritional Service Providers

    An individual who is a Board Certified Specialist for Obesity and Weight Management and educates, supports, and advocates for patients and clients to understand and manage their weight and associated risks through the use of nutritional, behavioral health, medical, surgical, pharmacotherapeutic, and exercise and physical activity interventions.

    Taxonomy code 133VN1201X
  • Dietetic Technician, Registered

    Dietary & Nutritional Service Providers

    A Dietetic Technician, Registered (DTR)/Nutrition and Dietetics Technician, Registered (NDTR) is an individual holding a nationally protected title issued by the Commission on Dietetic Registration (CDR) to qualified individuals who obtain an associate's degree or higher and successfully complete a sliding set of academic, examination, and practice requirements accredited by the Accreditation Council for Education in Nutrition and Dietetics (ACEND) or established by CDR, the nature of which are dependent upon the level of academic degree obtained. The scope of practice of the NDTR focuses on food, nutrition, and dietetics practice, as well as related services. NDTRs work under the supervision of a Registered Dietitian Nutritionist (RDN) when in direct patient/client nutrition care, and may work independently in providing general nutrition education to healthy populations. Patient/client populations include individuals receiving individualized care who have medical conditions or diseases, as well as at-risk individuals receiving personalized nutrition guidance as part of preventive health care.

    Taxonomy code 136A00000X
  • Health & Wellness Coach

    Other Service Providers

    The Health & Wellness Coach is trained in motivational theories, strategies, and communication techniques, which are used to assist patients to develop intrinsic motivation and obtain skills to create sustainable change for improved health and well-being. Health and wellness coaching is a patient-centered approach wherein patients at least partially determine their goals, use self-discovery or active learning processes together with content education to work toward their goals, and self-monitor behaviors to increase accountability, all within the context of an interpersonal relationship with a coach.

    Taxonomy code 171400000X
  • Driver

    Other Service Providers

    A person employed to operate a motor vehicle as a carrier of persons or property.

    Taxonomy code 172A00000X

Practice Locations

Practice Location

6637 N 58th Dr Apt 3

Glendale, Arizona 85301-3900

Phone: (480) 918-4775

Other Names

  • Mydung PhanReported February 12, 2025
  • Mydung Thi PhanReported February 12, 2025

Record Information

Enumeration Date
February 12, 2025
Provider's NPPES Record Last Updated
February 16, 2025
Certification Date
February 16, 2025
NPISignal NPPES Dataset
August 2026

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