| Kimberly Tangen Phd, Licensed Psychologist, Inc. | |
|
4519 Admiralty Way Ste 110 Marina Del Rey CA 90292-5455 | |
| (323) 538-4779 | |
| (323) 817-1150 |
| Full Name | Kimberly Tangen Phd, Licensed Psychologist, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 4519 Admiralty Way Ste 110, Marina Del Rey, California |
| Authorized Official Name and Position | Kimberly Anne Tangen (CEO) |
| Authorized Official Contact | 3235384779 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Tangen Phd, Licensed Psychologist, Inc. 8117 W Manchester Ave # 885 Playa Del Rey CA 90293-8211 Ph: (323) 538-4779 | Kimberly Tangen Phd, Licensed Psychologist, Inc. 4519 Admiralty Way Ste 110 Marina Del Rey CA 90292-5455 Ph: (323) 538-4779 |
| NPI Number | 1457806770 |
|---|---|
| Provider Enumeration Date | 08/16/2016 |
| Last Update Date | 12/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457806770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY 22865 (California) | Primary |
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