Healthcare Provider Details

I. General information

NPI: 1164860458
Provider Name (Legal Business Name): ELLEN S TAKHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELLEN S LAM MD

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 E THOUSAND OAKS BLVD UNIT 3462
THOUSAND OAKS CA
91359-7919
US

IV. Provider business mailing address

3435 E THOUSAND OAKS BLVD UNIT 3462
THOUSAND OAKS CA
91359-7919
US

V. Phone/Fax

Practice location:
  • Phone: 747-666-7496
  • Fax: 240-363-0010
Mailing address:
  • Phone: 747-666-7496
  • Fax: 240-363-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberA167681
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA167681
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: