Organization
THE PERMANENTE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY YEN PSY.D. (PSYCHOLOGIST)
(707) 645-2314
Entity
Organization
Contact information
Practice address
1761 BROADWAY ST, SUITE 100, VALLEJO, CA 94589-2226
(707) 645-2700
Mailing address
1761 BROADWAY ST, SUITE 100, VALLEJO, CA 94589-2226
(707) 645-2700
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PSY27745
CA
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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