KELLY PHAM

Psychologist - Clinical

Active Individual
NPI: 1114231669

Practice Address

1015 12TH ST STE 2
Modesto, CA 95354

Phone: (209) 496-2327

Specialties

Specialty Code Primary License
Student in an Organized Health Care Education/Training Program 390200000X No -
Psychologist - Clinical 103TC0700X Yes PSY29070 (CA)

Frequently Asked Questions

NPI 1114231669 is the National Provider Identifier for KELLY PHAM, a Psychologist - Clinical provider located in Modesto, CA. This NPI was enumerated on July 27, 2010.
KELLY PHAM practices at 1015 12TH ST STE 2, Modesto, CA 95354.

Quick Facts

NPI
1114231669
Type
Individual
Enumerated
Jul 27, 2010
Last Updated
Jan 22, 2023