Brooke Alyse Tannenbaum

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

17261 Issued in CA

Practice address

480 Alta Rd
San Diego, CA 92179-0001

Phone

(619) 661-6500

NPI assigned

Nov 28, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• State of California Prison Industry Authority

  • Eyewear Supplier
  • San Diego, CA
  • NPI 1356558001
  NPD (past)

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1275003642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "886 SUNNY BROOK WAY",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945663818",
            "telephone_number": "925-354-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 ALTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921790001",
            "telephone_number": "619-661-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "886 Sunny Brook Way",
            "address_purpose": "LOCATION",
            "city": "Pleasanton",
            "state": "CA",
            "postal_code": "945663818",
            "country_code": "US",
            "telephone_number": "925-354-9870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 The Alameda",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951261136",
            "country_code": "US",
            "telephone_number": "408-261-7777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 The Alameda",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951261136",
            "country_code": "US",
            "telephone_number": "408-261-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "BROOKE",
        "middle_name": "ALYSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "17261",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Rose Tank, DAOM, LMP
• Paramdeep Tank
• Mie Tankai, ND
• Dana Alyson Tankell, DC
• Tara Nicole Tanna
• Corinne Tanner
• Devin Andrew Tanner
• Natasha Amy Tanner, NNP
• Sarah Louise Tanner, MD
• Lianne Tannis, OTR

• Mental Health Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.