Healthcare Provider Details

I. General information

NPI: 1295102994
Provider Name (Legal Business Name): DIANA YEE PHAM PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANA YEE PSYD

II. Dates (important events)

Enumeration Date: 08/28/2015
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 BALBOA ST
SAN FRANCISCO CA
94121-2604
US

IV. Provider business mailing address

3626 BALBOA ST
SAN FRANCISCO CA
94121-2604
US

V. Phone/Fax

Practice location:
  • Phone: 415-668-5955
  • Fax:
Mailing address:
  • Phone: 415-668-5955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY35796
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: