Kelly T Pham
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 2Modesto, CA 95354-0838
Phone: (209) 496-2327
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Specialties & licences
| Clinical Psychologist (primary) | Taxonomy 103TC0700X · Licence PSY29070 (CA) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1114231669 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | July 27, 2010 |
| Last updated in NPPES | January 22, 2023 |
| Certification date | January 22, 2023 |
| Mailing address | 1015 12th St Ste 2, Modesto, CA 95354-0838 |
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