Ellen Marie Tan, MFT (CA)

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

CALMFT#23227 Issued in CA

Practice address

1625 So. Chelsea Rd. Ellen M. Tan, MFT
San Marino, CA 91108

Phone

(626) 458-2934

NPI assigned

Mar 3, 2016

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": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1629438643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SO. CHELSEA RD. ELLEN M. TAN, MFT",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "91108",
            "telephone_number": "626-458-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SO. CHELSEA RD. ELLEN M. TAN, MFT",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "91108",
            "telephone_number": "626-458-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MFT (CA)",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "CALMFT#23227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Song Dental Corporation
• David Matthe Speiser, MD
• Kenneth Richard Stroud, D.D.S.
• Sunshine Acupuncture, Inc.
• Daniel Thomas Suzuki, M.D.
• Afton C Taylor
• Linda Taylor
• Teh-Shu Yang
• Shendee Teng, M.D.
• Khanh-Long Thai, PHARMD.

• Marriage & Family Therapist in San Marino, CA
• Providers in San Marino, 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 Mar 3, 2016; 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.