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General NPI Number Information
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NPI Number | 1285250639
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Entity Type | Individual
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Provider Name | CHRISTINE VIKKI CHAN PSYD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2020
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 2325 CLEMENT AVE
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City | ALAMEDA
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State | CA
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Zip | 94501-7063
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Country | US
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Telephone | 510-629-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 700 EDGEWATER BLVD APT 301
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City | FOSTER CITY
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State | CA
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Zip | 94404-2847
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Country | US
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Telephone | 408-781-6949
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35686
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License Number State | CA
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