Healthcare Provider Details

I. General information

NPI: 1710283684
Provider Name (Legal Business Name): TONY TZENG MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2011
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 PASADENA AVE
SOUTH PASADENA CA
91030-2919
US

IV. Provider business mailing address

205 PASADENA AVE
SOUTH PASADENA CA
91030-2919
US

V. Phone/Fax

Practice location:
  • Phone: 323-344-5536
  • Fax:
Mailing address:
  • Phone: 323-344-5536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: