Tara Christine Egemo, LMFT
Individual provider Active NPI Marriage & Family Therapist · San Marino, CA
NPI 1073078028 · NPPES record last updated Mar 11, 2019
Key facts
- NPI
- 1073078028
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 105845 (CA)
- Practice address
- 2627 Mission St
San Marino, CA 91108-1639 - Phone
- (619) 865-4783
- NPI assigned
- Feb 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105845 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellbeings Family Therapy, Inc. | Marriage & Family Therapist | Past |
Accepting new patients |
| Silver Lake Psychology Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 105845 | CA | Yes |
Addresses
Primary practice location
2627 Mission St
San Marino, CA 91108-1639
Mailing address
6132 Zelzah Ave
Encino, CA 91316-7127
Phone (619) 865-4783
Other practice location 1
2120 Huntington Dr Ste A
South Pasadena, CA 91030-4984
Phone (626) 720-4471
Other providers in San Marino, CA
- Rita Dosti
- Daniel F Doyle
- Dr Toan a Nguyen OD Inc
- Gin Gin Du
- Xiaoli Du
- Sonya M Ehresmann
- Tonya Renee El-Hendi
- Elisa C Alvarado MD Inc
- Brittany Eng
- Epeius Biotechnologies Corporation
All providers in San Marino, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.