Provider Demographics
NPI:1174689798
Name:EICHEN, TAMA WENDY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TAMA
Middle Name:WENDY
Last Name:EICHEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2612
Mailing Address - Country:US
Mailing Address - Phone:650-299-4908
Mailing Address - Fax:650-299-2655
Practice Address - Street 1:1400 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2612
Practice Address - Country:US
Practice Address - Phone:650-299-4908
Practice Address - Fax:650-299-2655
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS156461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical