Amy Marie Tetalman, M.A., MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

84544 Issued in CA

Practice address

5901 Encina Rd
Suite a
Goleta, CA 93117-2269

Phone

(805) 681-0035

Fax

(805) 681-0029

NPI assigned

Apr 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amy Marie Lenz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sbbh.amytetalman@144896.advancedmd-direct.com

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.

• Santa Barbara Behavioral Health, a Psychological Corporation

  • Psychiatry Physician
  • Goleta, CA
  • NPI 1528182573
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1881812840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 ROSARIO DR",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931101121",
            "telephone_number": "805-636-5366",
            "fax_number": "805-681-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 ENCINA RD",
            "address_2": "SUITE A",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931172269",
            "telephone_number": "805-681-0035",
            "fax_number": "805-681-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETALMAN",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.A., MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 56685",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "84544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "LENZ",
            "middle_name": "MARIE",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hwai-En Jubilee Tang, O.D.
• Caleb D Tarman
• Jane Frances Taylor, LMFT
• Kathleen M Taylor, PHD
• Jordan Philip Tennison
• The Devereux Foundation - California
• The Eyelid Doc, Inc.
• The Medcenter, Inc.
• The Phoenix House of Santa Barbara
• John Michael Thompson, DDS

• Marriage & Family Therapist in Goleta, CA
• Providers in Goleta, 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 Jan 6, 2015; 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.