Individual provider Active NPI

Tanisha Inez South

  • Marriage & Family Therapist
  • Sacramento, CA
National Provider Identifier
1235420936
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
102772 Issued in CA
Practice address
9121 Folsom Blvd
Sacramento, CA 95826-2473
Phone
(916) 743-2661
Fax
(916) 743-2661
NPI assigned
Apr 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 102772 CA Primary

Addresses

Primary practice location

9121 Folsom Blvd
Sacramento, CA 95826-2473

Mailing address

3239 Miramonte Dr
Sacramento, CA 95833-2624
Phone (916) 473-5766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
102772CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1235420936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3239 MIRAMONTE DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958332624",
            "telephone_number": "916-473-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9121 FOLSOM BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262473",
            "telephone_number": "916-743-2661",
            "fax_number": "916-743-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTH",
        "first_name": "TANISHA",
        "middle_name": "INEZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.