Doctor Name: | DR. BETH COOPER TABAKIN |
NPI Number: | 1114142361 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | PSY13580 |
Business Practice Address: | 412 Red Hill Ave Suite #6 San Anselmo, CA - 949602450 |
Business Phone Number: | 4154597707 |
Business Fax Number: | |
Mailing Address: | Po Box 823, FOREST KNOLLS |
State: | CA |
Postal Code: | 949330823 |
Phone Number: | 4154889108 |
Fax Number: | |
NPI Enumeration Date: | 04/14/2007 |
NPI Last Update Date: | 10/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY13580 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |