Tanisha N Tatum, LEP is a
Psychologist based in Los Angeles, California. Tanisha N Tatum is licensed to practice in California (license number 3897) and her current practice location is
5777 W Century Blvd # 11102035, Los Angeles, California. She can be reached at her office (for appointments etc.) via phone at
(424) 248-7355.
NPI number for Tanisha N Tatum is 1619504925 and her current mailing address is 360 N Pacific Coast Hwy Ste 2000, El Segundo, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1619504925.
Healthcare Provider's Profile
| Full Name | Tanisha N Tatum |
|---|
| Gender | Female |
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| Speciality | Psychologist |
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| Location | 5777 W Century Blvd # 11102035, Los Angeles, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1619504925
- Provider Enumeration Date: 03/25/2020
- Last Update Date: 06/13/2023
Medical Identifiers
Medical identifiers for Tanisha N Tatum such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619504925 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | 3897 (California) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 103TS0200X | Psychologist - School | 3897 (California) | Secondary |
| 225400000X | Rehabilitation Practitioner | (California) | Secondary |
| 103T00000X | Psychologist | 3897 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tanisha N Tatum is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tanisha N Tatum, LEP
360 N Pacific Coast Hwy Ste 2000,
El Segundo, CA 90245-4532
Ph: (424) 248-7355 | Tanisha N Tatum, LEP
5777 W Century Blvd # 11102035,
Los Angeles, CA 90045-5600
Ph: (424) 248-7355 |
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