Healthcare Provider Details
I. General information
NPI: 1679831432
Provider Name (Legal Business Name): PHILLIP L YEE M.A. , LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/30/2012
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7200 BANCROFT AVE STE 133
OAKLAND CA
94605-2480
US
IV. Provider business mailing address
7200 BANCROFT AVE STE 133
OAKLAND CA
94605-2480
US
V. Phone/Fax
- Phone: 510-418-5171
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 129637 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: