Individual
DR. AUDREY D HAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
380 SOUTH LAKE, SUITE 205, PASADENA, CA 91101
(626) 319-6327
Mailing address
380 S LAKE AVE, SUITE 205, PASADENA, CA 91101-3525
(626) 319-6327
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY22723
CA
103TC0700X
Clinical Psychologist
016612-1
NY
103TC0700X
Clinical Psychologist
PSY -953
HI
Other
Enumeration date
08/14/2006
Last updated
02/09/2015
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