Healthcare Provider Details

I. General information

NPI: 1053623736
Provider Name (Legal Business Name): MARLENE JANET TAMAYO-TRAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9291 OLD REDWOOD HWY BLDG 500
WINDSOR CA
95492-8089
US

IV. Provider business mailing address

PO BOX 127
NAPA CA
94559-0127
US

V. Phone/Fax

Practice location:
  • Phone: 707-837-7701
  • Fax:
Mailing address:
  • Phone: 707-255-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number121272
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: