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NPI Code Detail

MEDICARE: TIONG YEE TAN LCSW

MEDICARE: TIONG YEE TAN LCSW
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
11041C0700XClinical Social Worker88693CA

General Provider Information

NPI Number : 1275999690
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIONG YEE TAN LCSW
Provider Business Mailing Address
First Line : 14271 JEFFREY RD # 220
Second Line :
City : IRVINE
State : CA
Zip : 92620-3405
Country : US
Telephone Number : 949-648-8305
Fax Number :
Provider Business Practice Location Address
First Line : 5000 BIRCH ST STE 3000
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-2140
Country : US
Telephone Number : 949-229-6943
Fax Number : 949-576-3913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2016
Last Update Date : 11/16/2024

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Directions to “ TIONG YEE TAN LCSW” Practice Location

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