IndividualActive
Kelly Phan
NPI 1407609654 · Behavior Technician · Fremont, CA
Kelly Phan is a Behavior Technician provider in Fremont, CA (NPI 1407609654).
Provider details
- NPI number
- 1407609654
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 46-1305562 (CA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
39210 State St Ste 220
Fremont, CA 94538-1456
Phone: (510) 894-4135
Approximate (ZIP-level) locationGet directions
Mailing address
255 Union Ave Apt D1073
Campbell, CA 95008-3541
Registry dates
- Enumerated
- 2024-04-08
- Last updated
- 2024-04-08
- Certified
- 2024-04-08
Frequently asked questions
- What is Kelly Phan's NPI number?
- Kelly Phan's National Provider Identifier (NPI) is 1407609654, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kelly Phan's specialty?
- Kelly Phan is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).
- Where is Kelly Phan located?
- Kelly Phan's practice location on file with NPPES is 39210 State St Ste 220, Fremont, CA 94538-1456.
- What is Kelly Phan's phone number?
- The practice phone number listed in the NPPES registry for Kelly Phan is (510) 894-4135.
- Is Kelly Phan's NPI active?
- Yes — Kelly Phan's NPI (1407609654) is active in the NPPES registry as of the last update on 2024-04-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.