Provider Demographics
NPI:1093119257
Name:TAUREK, DAVIDA (LPCC)
Entity Type:Individual
Prefix:
First Name:DAVIDA
Middle Name:
Last Name:TAUREK
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TAMAL VISTA BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1147
Mailing Address - Country:US
Mailing Address - Phone:415-448-6780
Mailing Address - Fax:
Practice Address - Street 1:21 TAMAL VISTA BLVD STE 205
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1147
Practice Address - Country:US
Practice Address - Phone:415-448-6780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPCCI3220101YP2500X
CALPCC6939101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional