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KELLY T PHAM
NPI 1114231669
Psychologist - Clinical in Modesto, CA

Active since July 27, 2010PECOS Enrolled
1015 12TH ST STE 2, MODESTO, CA 95354(209) 496-2327 Get Directions Write a Review

NPPES record last updated: January 22, 2023. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Kelly T Pham NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY T PHAM (NPI 1114231669) is an individual clinical provider in Modesto, California, licensed in California (PSY29070) and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114231669
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameKELLY T PHAM
Location Address1015 12TH ST STE 2Modesto, CA 95354-0838
Mailing Address1015 12th St Ste 2Modesto, CA 95354-0838 · (209) 496-2327
Phone(209) 496-2327
Sole ProprietorYes
Enumeration DateJuly 27, 2010
Last NPPES UpdateJanuary 22, 2023
NPPES CertifiedJanuary 22, 2023
✔ NPI 1114231669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY29070
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1015 12TH ST STE 2, Modesto, CA 95354
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly T Pham is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95354 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$176.60 typical visit price
range $58.87 – $176.60
Typical copayment $44.15 (range $14.71 – $44.15)
Most-billed visit code 99205
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Pham's NPI number?

The NPI number for Kelly Pham is 1114231669. It was assigned to this individual provider in the NPPES registry on July 27, 2010.

Where is Kelly Pham located?

Kelly Pham practices at 1015 12th St Ste 2, Modesto, CA 95354. The listed phone number is (209) 496-2327.

What is Kelly Pham's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Kelly Pham enrolled in Medicare?

Yes. Kelly Pham is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Pham was last updated on January 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.