Provider Demographics
NPI:1518337781
Name:HALL, TARA (LMFT)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94573-0009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:497 WALNUT ST
Practice Address - Street 2:SUITE F
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-3102
Practice Address - Country:US
Practice Address - Phone:707-295-8595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87938106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist