Individual provider Active NPI

Yuen Sin Larissa Tam

  • Mental Health Counselor
  • San Francisco, CA
National Provider Identifier
1316509748
Registry record updated Jul 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4020 Balboa St
San Francisco, CA 94121-2569
Phone
(415) 668-5998
NPI assigned
Jul 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4020 Balboa St
San Francisco, CA 94121-2569

Mailing address

4020 Balboa St
San Francisco, CA 94121-2569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241204002584 CA Practitioner - Mental Health Counselor 9032645817 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Nov 8, 2024 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562371200000",
    "number": "1316509748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 BALBOA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941212569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 BALBOA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941212569",
            "telephone_number": "415-668-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "YUEN SIN LARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-06",
        "last_updated": "2019-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.