Provider Demographics
NPI:1881726438
Name:TANAMACHI, LINDA F (LCSW, MFT)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:F
Last Name:TANAMACHI
Suffix:
Gender:F
Credentials:LCSW, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W VICTORIA ST
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-3523
Mailing Address - Country:US
Mailing Address - Phone:310-714-2020
Mailing Address - Fax:310-715-1294
Practice Address - Street 1:5311 FANWOOD DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-4721
Practice Address - Country:US
Practice Address - Phone:714-846-7256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66161041C0700X
CA12077106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist