| Kelly T Pham, | |
|
1015 12th St Ste 2, Modesto, CA 95354-0838 | |
| (209) 496-2327 | |
| Not Available |
| Full Name | Kelly T Pham |
|---|---|
| Gender | Female |
| Speciality | Psychologist - Clinical |
| Location | 1015 12th St Ste 2, Modesto, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114231669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY29070 (California) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Entity Name | Department of State Hospitals |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124078704 PECOS PAC ID: 9638174238 Enrollment ID: O20081031000305 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly T Pham, 1015 12th St Ste 2, Modesto, CA 95354-0838 Ph: (209) 496-2327 | Kelly T Pham, 1015 12th St Ste 2, Modesto, CA 95354-0838 Ph: (209) 496-2327 |
Dr. Kurt Dayne Baker, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4125 Bangs Ave, Modesto, CA 95356 Phone: 209-557-2300 |
Dr. Elizabeth Marshall Swearingen, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1518 Coffee Rd, Ste. C, Modesto, CA 95355 Phone: 209-577-4059 Fax: 209-572-2469 |
Dr. Marlene Cresci Cohen, PHD, PSYCHOLOGIST Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1015 12th St, Modesto, CA 95354 Phone: 209-522-2992 Fax: 209-522-2993 |
Dr. James Oral Henman, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 706 13th St, Modesto, CA 95354 Phone: 209-577-1667 Fax: 209-577-3805 |
Mary Ly Vasche, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 426 Locust St, Modesto, CA 95351 Phone: 209-574-1500 |
Juliana Torres, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 426 Locust St, Modesto, CA 95351 Phone: 209-574-1500 |
Marisol Ramirez, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 426 Locust St, Modesto, CA 95351 Phone: 209-985-5237 |