Healthcare Provider Details

I. General information

NPI: 1902772759
Provider Name (Legal Business Name): TIMOTHY YEN, PSY.D., A PROFESSIONAL PSYCHOLOGY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 MARIA LN STE 310
WALNUT CREEK CA
94596-8803
US

IV. Provider business mailing address

1433 RAMSAY CIR
WALNUT CREEK CA
94597-2342
US

V. Phone/Fax

Practice location:
  • Phone: 925-385-8228
  • Fax:
Mailing address:
  • Phone: 925-385-8228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TIMOTHY YEN
Title or Position: OWNER/CEO
Credential: PSYD
Phone: 714-726-5051