Elly Lin, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

24380 Issued in CA

Practice address

110 Gough St Ste 203
San Francisco, CA 94102

Phone

(415) 236-3819

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Healthright 360

  • Community/Behavioral Health Agency
  • South San Francisco, CA
  • NPI 1265563688
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1992878342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 17TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161245",
            "telephone_number": "415-236-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 GOUGH ST STE 203",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94102",
            "telephone_number": "415-236-3819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Clement St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941182419",
            "country_code": "US",
            "telephone_number": "415-236-3819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "ELLY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Lin, MD
• Daniel Lin, OTR/L
• Danny Y Lin, MD
• Diana Fong Ni Lin, RN
• Dong Lin, MD PHD
• Eric Lin
• Eric Chia Chen Lin
• Eric Yu-Kai Lin, M.D.
• Erica Vivian Lin
• Grace Adelaide Lin, MD

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.