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Individual

DYLAN PHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2828 FORD ST, OAKLAND, CA 94601-2114
(510) 268-3770
Mailing address
3709 GENOVA LN, STOCKTON, CA 95212-3511
(978) 770-9316

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
106S00000X
Behavior Technician
Primary
373H00000X
Day Training/Habilitation Specialist
Primary
CA

Other

Enumeration date
06/20/2024
Last updated
03/09/2026
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