Healthcare Provider Details

I. General information

NPI: 1922254077
Provider Name (Legal Business Name): ALICE JYH-FARN LI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 01/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 SARATOGA AVE SUITE 14
SAN JOSE CA
95129-3440
US

IV. Provider business mailing address

1175 SARATOGA AVE SUITE 14
SAN JOSE CA
95129-3440
US

V. Phone/Fax

Practice location:
  • Phone: 408-996-7950
  • Fax: 408-996-7997
Mailing address:
  • Phone: 408-996-7950
  • Fax: 408-996-7997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA97107
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA97107
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: