Healthcare Provider Details

I. General information

NPI: 1598406183
Provider Name (Legal Business Name): RYAN W YAM PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11844 DUBLIN BLVD STE D
DUBLIN CA
94568-2800
US

IV. Provider business mailing address

6483 LAGUNA MIRAGE LN
ELK GROVE CA
95758-5464
US

V. Phone/Fax

Practice location:
  • Phone: 415-350-1092
  • Fax:
Mailing address:
  • Phone: 415-350-1092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: