| Mr Jack S Tanenbaum, LCSW | |
|
1920 Tienda Dr, Ste 101, Lodi, CA 95242-3930 | |
| (916) 662-5947 | |
| (209) 366-1133 |
| Full Name | Mr Jack S Tanenbaum |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 1920 Tienda Dr, Lodi, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154419505 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LCS 1098 (California) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jack S Tanenbaum, LCSW 2715 W Kettleman Ln, Ste 203-113, Lodi, CA 95242-9289 Ph: (916) 662-5947 | Mr Jack S Tanenbaum, LCSW 1920 Tienda Dr, Ste 101, Lodi, CA 95242-3930 Ph: (916) 662-5947 |
Richard Jesus Ortega, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1305 E Vine St, Lodi, CA 95240 Phone: 209-879-1145 | |
Esperanza Gonzales, Counselor Medicare: Not Enrolled in Medicare Practice Location: 541 S Ham Ln Ste A&b, Lodi, CA 95242 Phone: 209-224-8940 | |
Jane Knox, Counselor Medicare: Not Enrolled in Medicare Practice Location: 12755 N Highway 88, Lodi, CA 95240 Phone: 209-340-5800 Fax: 209-340-5804 | |
Evelyn Gonzalez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 12755 N Highway 88, Lodi, CA 95240 Phone: 209-340-5800 | |
Ms. Jennifer Preap, Counselor Medicare: Not Enrolled in Medicare Practice Location: 541 S Ham Ln Ste B, Lodi, CA 95242 Phone: 209-224-8940 | |
Patricia Josephine Block, Counselor Medicare: Not Enrolled in Medicare Practice Location: 541 S Ham Ln, Lodi, CA 95242 Phone: 209-224-5076 | |
Curtis Perkins, Counselor Medicare: Not Enrolled in Medicare Practice Location: 12755 N Highway 88, Lodi, CA 95240 Phone: 209-340-7900 |