Tanenbaum, Keith John

Tanenbaum, Keith John is an sole proprietor health care provider with primary practice located at 924 Emerald Bay Rd First Floor, South Lake Tahoe CA 96150. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Tanenbaum, Keith John can be contacted via phone (530) 782-9889.

Contact Information

Primary practice address
924 Emerald Bay Rd First Floor South Lake Tahoe CA 96150
Phone: (530) 782-9889
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 89589 California
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 2084H0002X 107074 California
Behavioral Health & Social Service Providers / Clinical 1041C0700X 107974 California

Profile Details

NPI number 1477169605
LBN Legal business name Tanenbaum, Keith John
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 22nd, 2020
Last updated Oct 5th, 2022 - about 3 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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