Stacey Diane Tannenbaum, MA. L.M.F.T.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC33404 Issued in CA

Practice address

601 S Glenoaks Blvd
Suite 200
Burbank, CA 91502-1474

Phone

(818) 441-7800

NPI assigned

Mar 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114056629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 ASHLAND AVE",
            "address_2": "#5",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054537",
            "telephone_number": "310-962-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S GLENOAKS BLVD",
            "address_2": "SUITE 200",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021474",
            "telephone_number": "818-441-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "STACEY",
        "middle_name": "DIANE",
        "credential": "MA. L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC33404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie Tam, BCBA
• Michelle P Tamondong, PT
• Edward Arvizu Tan, LMFT
• James Tan
• David Alan Tang, DPT
• Jennifer Kristin Tapia, LMFT
• Eldad Tarmu
• Jonathan Tase
• Robert S Tasoff, PH.D.
• Raymond G. Tatevossian, M.D.

• Marriage & Family Therapist in Burbank, CA
• Providers in Burbank, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.