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NPI Code Detail

MEDICARE: MR. ANH TA

MEDICARE: MR. ANH TA
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
1101YM0800XMental Health Counselor
2106H00000XMarriage & Family Therapist85506CA

General Provider Information

NPI Number : 1508099888
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANH TA
Provider Business Mailing Address
First Line : 1218 GUSTY LOOP
Second Line :
City : LIVERMORE
State : CA
Zip : 94550-2543
Country : US
Telephone Number : 510-258-2737
Fax Number :
Provider Business Practice Location Address
First Line : 2828 FORD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2114
Country : US
Telephone Number : 510-292-3585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2009
Last Update Date : 02/03/2022

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