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NPI Code Detail

MEDICARE: DR. JENNY YIP PSYD

MEDICARE: DR. JENNY YIP PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY22024CA

General Provider Information

NPI Number : 1104278100
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNY YIP PSYD
Provider Business Mailing Address
First Line : 3002 DOW AVE STE 122
Second Line :
City : TUSTIN
State : CA
Zip : 92780-7247
Country : US
Telephone Number : 949-328-7688
Fax Number :
Provider Business Practice Location Address
First Line : 3002 DOW AVE STE 122
Second Line :
City : TUSTIN
State : CA
Zip : 92780-7247
Country : US
Telephone Number : 949-328-7688
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2016
Last Update Date : 07/01/2016

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Directions to “ DR. JENNY YIP PSYD” Practice Location

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