Provider Demographics
NPI:1659661775
Name:SY, JOHN RICHMOND TAN
Entity Type:Individual
Prefix:
First Name:JOHN RICHMOND
Middle Name:TAN
Last Name:SY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ARCO WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-2403
Mailing Address - Country:US
Mailing Address - Phone:310-634-7534
Mailing Address - Fax:
Practice Address - Street 1:1038 POST ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5603
Practice Address - Country:US
Practice Address - Phone:415-775-2636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health