Provider Demographics
NPI:1225220007
Name:TARVINS, DENISE (LMFT 107650)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:TARVINS
Suffix:
Gender:F
Credentials:LMFT 107650
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 BISSO LN STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4817
Mailing Address - Country:US
Mailing Address - Phone:925-521-5620
Mailing Address - Fax:
Practice Address - Street 1:2425 BISSO LN STE 100
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4817
Practice Address - Country:US
Practice Address - Phone:925-521-5620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61762106H00000X
CA107650106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist