person
Mr. Jack S. Tanenbaum, LCSW
Mental Health Counselor in Lodi, California
NPI 1154419505

Jack S. Tanenbaum is a Mental Health Counselor based in Lodi, CA and is specialized in Mental Health. Jack S. Tanenbaum practices in Lodi, CA and has the professional credentials of LCSW. The NPI Number for Jack S. Tanenbaum is 1154419505 and holds a License No. LCS 1098 (California).

The current practice location address for Jack S. Tanenbaum is 1920 Tienda Dr, Lodi, CA and can be reached out via phone at 916-662-5947 and via fax at 209-366-1133.

Location: 1920 Tienda Dr, Lodi, CA, 95242-9289
person
Provider Profile Details
NPI Number
1154419505
Provider Name
Jack S. Tanenbaum
Credential
LCSW
Provider Entity Type
Individual
Gender
Male
Address
1920 Tienda Dr, Lodi, CA, 95242-9289
Phone Number
916-662-5947
Fax Number
209-366-1133
Provider Enumeration Date
10/11/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1920 Tienda Dr
City
State
Zip
95242-3930
Phone Number
916-662-5947
Fax Number
209-366-1133
person
Provider Business Mailing Address Details
Address
1920 Tienda Dr
City
State
Zip
95242-3930
Phone Number
916-662-5947
Fax Number
209-366-1133
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LCS 1098 (California)
Definition
Definition to come...
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