Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly T Pham

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1114231669

Kelly T Pham is a Student in an Organized Health Care Education/Training Program in Modesto, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2010
Specialties on file
2

Practice location Address checks out

1015 12th St Ste 2
Modesto, CA 95354-0838
Phone: (209) 496-2327
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY29070 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1114231669
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 27, 2010
Last updated in NPPESJanuary 22, 2023
Certification dateJanuary 22, 2023
Mailing address1015 12th St Ste 2, Modesto, CA 95354-0838

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