Healthcare Provider Details

I. General information

NPI: 1093646358
Provider Name (Legal Business Name): JANE YAM
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 OAKDALE AVE
SAN FRANCISCO CA
94124-2323
US

IV. Provider business mailing address

1520 OAKDALE AVE
SAN FRANCISCO CA
94124-2323
US

V. Phone/Fax

Practice location:
  • Phone: 628-900-1340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number05262026914308
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: