Healthcare Provider Details

I. General information

NPI: 1306757877
Provider Name (Legal Business Name): TAWNY ESTES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 E THOUSAND OAKS BLVD STE 103
THOUSAND OAKS CA
91360-7706
US

IV. Provider business mailing address

3645 E THOUSAND OAKS BLVD # 1086
WESTLAKE VILLAGE CA
91362-3606
US

V. Phone/Fax

Practice location:
  • Phone: 323-540-4720
  • Fax:
Mailing address:
  • Phone: 805-888-2414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT162057
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: