Tanenbaum, Jack S.

Tanenbaum, Jack S. is an sole proprietor health care provider with primary practice located at 1920 Tienda Dr Ste 101, Lodi CA 95242-3930. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Tanenbaum, Jack S. can be contacted via phone (916) 662-5947.

Contact Information

Primary practice address
1920 Tienda Dr Ste 101 Lodi CA 95242-3930
Phone: (916) 662-5947
Fax: (209) 366-1133
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LCS 1098 California

Profile Details

NPI number 1154419505
LBN Legal business name Tanenbaum, Jack S.
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2006
Last updated Oct 1st, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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