Provider Demographics
NPI:1194918524
Name:YI, JANE ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:ELIZABETH
Last Name:YI
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:2010 EDDY ST
Mailing Address - Street 2:C
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3998
Mailing Address - Country:US
Mailing Address - Phone:415-237-0377
Mailing Address - Fax:415-484-1944
Practice Address - Street 1:1939 DIVISADERO ST
Practice Address - Street 2:5 B
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2507
Practice Address - Country:US
Practice Address - Phone:415-237-0377
Practice Address - Fax:415-484-1944
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2013-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA25508103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA25508OtherLICENSE NUMBER