MEDICARE: MRS. LINDA F TANAMACHI LCSW, MFT

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	1041C0700X	Clinical Social Worker	6616	CA
2	106H00000X	Marriage & Family Therapist	12077	CA

General Provider Information

NPI Number	:	1881726438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA F TANAMACHI LCSW, MFT

Provider Business Mailing Address
First Line	:	108 W VICTORIA ST
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90248-3523
Country	:	US
Telephone Number	:	310-714-2020
Fax Number	:	310-715-1294

Provider Business Practice Location Address
First Line	:	5311 FANWOOD DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4721
Country	:	US
Telephone Number	:	714-846-7256
Fax Number	:

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

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	09/11/2025

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