Healthcare Provider Details

I. General information

NPI: 1275424244
Provider Name (Legal Business Name): LINDA NANCY TANG AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA NANCY TANG AMFT

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 COUNTY SQUARE DR STE 111
VENTURA CA
93003-5473
US

IV. Provider business mailing address

950 COUNTY SQUARE DR
VENTURA CA
93003-5410
US

V. Phone/Fax

Practice location:
  • Phone: 805-620-8046
  • Fax:
Mailing address:
  • Phone: 805-620-8046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number141485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: