Basic Information
| Provider Information | |||||||||
| NPI: | 1235208240 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAMATE | ||||||||
| FirstName: | MICHIKO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 642881 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941642881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152676171 | ||||||||
| FaxNumber: | 4156748070 | ||||||||
| Practice Location | |||||||||
| Address1: | 2859 SACRAMENTO ST STE 5 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941152114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152676171 | ||||||||
| FaxNumber: | 4156748070 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2006 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | IMF 51172 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 106H00000X | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.