Provider Demographics
NPI:1609266766
Name:PHAM, UYEN QUYNH (BA)
Entity Type:Individual
Prefix:MS
First Name:UYEN
Middle Name:QUYNH
Last Name:PHAM
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2839 DEERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2626
Mailing Address - Country:US
Mailing Address - Phone:469-475-3334
Mailing Address - Fax:
Practice Address - Street 1:37 CLINTON ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-1595
Practice Address - Country:US
Practice Address - Phone:650-367-9610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health