MEDICARE: TATIANA KWANAE GARRETT-THOMPSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LMFT163598	CA
2	106H00000X	Marriage & Family Therapist	AMFT119136	CA
3	106H00000X	Marriage & Family Therapist	119136	CA

General Provider Information

NPI Number	:	1144822784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TATIANA KWANAE GARRETT-THOMPSON

Provider Business Mailing Address
First Line	:	650 HOWE AVE BLDG 400-B
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-4731
Country	:	US
Telephone Number	:	916-549-8028
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 HOWE AVE BLDG 400-B
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-4731
Country	:	US
Telephone Number	:	916-549-8028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2020
Last Update Date	:	05/26/2026

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Directions to “ TATIANA KWANAE GARRETT-THOMPSON ” Practice Location

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