Healthcare Provider Details

I. General information

NPI: 1811670714
Provider Name (Legal Business Name): JESSICA ERIN YIP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 LINDEN ST
OAKLAND CA
94607-2538
US

IV. Provider business mailing address

150 LINDEN ST
OAKLAND CA
94607-2538
US

V. Phone/Fax

Practice location:
  • Phone: 510-273-4700
  • Fax:
Mailing address:
  • Phone: 510-273-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number140996
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14405
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: