Healthcare Provider Details
I. General information
NPI: 1699076489
Provider Name (Legal Business Name): TAMARA CATES-PALMERLEE MFTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/09/2010
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15339 SATICOY ST
VAN NUYS CA
91406-3345
US
IV. Provider business mailing address
15339 SATICOY ST
VAN NUYS CA
91406-3345
US
V. Phone/Fax
- Phone: 818-267-2600
- Fax: 818-267-2691
- Phone: 818-267-2600
- Fax: 818-267-2691
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 63989 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: