Provider Demographics
NPI:1790926392
Name:TANSEK, JOSEPH ALEXANDER (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ALEXANDER
Last Name:TANSEK
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 BEND AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136-1802
Mailing Address - Country:US
Mailing Address - Phone:408-649-4007
Mailing Address - Fax:
Practice Address - Street 1:621 E CAMPBELL AVE STE 8
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2126
Practice Address - Country:US
Practice Address - Phone:408-649-4007
Practice Address - Fax:408-295-4081
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X, 101YP2500X
CAMFC 47964106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA462521OtherMHN PROVIDER ID
CA818811368OtherUBH PROVIDER NUMBER
CAMFT479640OtherBLUE SHIELD PROVIDER ID