Provider Demographics
NPI:1164584900
Name:AGATEP, DENISE KATHEN TAN (LCSW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:KATHEN TAN
Last Name:AGATEP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:KATHEN
Other - Last Name:TAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:39400 PASEO PADRE PKWY
Mailing Address - Street 2:NILES WEST BLDG, 3RD FLR
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2310
Mailing Address - Country:US
Mailing Address - Phone:510-248-3283
Mailing Address - Fax:510-248-3551
Practice Address - Street 1:39400 PASEO PADRE PKWY
Practice Address - Street 2:NILES WEST BLDG, 3RD FLR
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2310
Practice Address - Country:US
Practice Address - Phone:510-248-3283
Practice Address - Fax:510-248-3551
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor