Healthcare Provider Details

I. General information

NPI: 1043625767
Provider Name (Legal Business Name): LIPSCHUTZ TALAMO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 SAN PABLO AVE STE 8
ALBANY CA
94706-2277
US

IV. Provider business mailing address

1035 SAN PABLO AVE STE 8
ALBANY CA
94706-2277
US

V. Phone/Fax

Practice location:
  • Phone: 510-323-2488
  • Fax: 877-325-5880
Mailing address:
  • Phone: 510-323-2488
  • Fax: 877-325-5880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. ANNA TALAMO
Title or Position: MFT/OWNER
Credential: MA
Phone: 510-323-2488