| Stan Tatkin, Psyd, Mft | |
|
5012 Chesebro Rd Suite 201 Agoura Hills CA 91301-2272 | |
| (805) 300-3074 | |
| (805) 300-3074 |
| Full Name | Stan Tatkin, Psyd, Mft |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 5012 Chesebro Rd, Agoura Hills, California |
| Authorized Official Name and Position | Stan Tatkin (OWNER) |
| Authorized Official Contact | 8053003074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stan Tatkin, Psyd, Mft 5012 Chesebro Rd Suite 201 Agoura Hills CA 91301-2272 Ph: (805) 300-3074 | Stan Tatkin, Psyd, Mft 5012 Chesebro Rd Suite 201 Agoura Hills CA 91301-2272 Ph: (805) 300-3074 |
| NPI Number | 1568998342 |
|---|---|
| Provider Enumeration Date | 05/11/2017 |
| Last Update Date | 05/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568998342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | MFT 29303 (California) | Primary |
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