Healthcare Provider Details

I. General information

NPI: 1982944856
Provider Name (Legal Business Name): TAMARA GOLD L.C.S.W
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2013
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 TARZANA WOODS DR
TARZANA CA
91356-4429
US

IV. Provider business mailing address

4920 TARZANA WOODS DR
TARZANA CA
91356-4429
US

V. Phone/Fax

Practice location:
  • Phone: 310-721-1584
  • Fax:
Mailing address:
  • Phone: 310-721-1584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05528100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL16530
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number136364
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: