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NPI Code Detail

MEDICARE: IVANA TUFEKCIC MS

MEDICARE: IVANA TUFEKCIC MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorPCI323CA
2106H00000XMarriage & Family TherapistIMF76917CA
3106H00000XMarriage & Family Therapist105735CA

General Provider Information

NPI Number : 1154752491
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVANA TUFEKCIC MS
Provider Business Mailing Address
First Line : 3010 I ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95816-4420
Country : US
Telephone Number : 916-606-7458
Fax Number :
Provider Business Practice Location Address
First Line : 3010 I ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95816-4420
Country : US
Telephone Number : 916-606-7458
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2013
Last Update Date : 01/23/2020

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