Provider Demographics
NPI:1083104079
Name:TENZERA, ANITA
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:TENZERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:
Other - Last Name:STANICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:2113 VOORHEES AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-2459
Mailing Address - Country:US
Mailing Address - Phone:310-365-7484
Mailing Address - Fax:424-247-9380
Practice Address - Street 1:2100 N SEPULVEDA BLVD STE 18
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2959
Practice Address - Country:US
Practice Address - Phone:310-365-7484
Practice Address - Fax:424-247-9380
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103149106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist