# LA TANYA TAKLA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265799951
- **Authorized official:** MRS. LA TANYA ALICIA TAKLA LMFT (MARRIAGE AND FAMILY THERAPIST)
- **Authorized official phone:** (650) 454-6109

## Contact information

- **Practice address:** 1652 W TEXAS ST, SUITE 131, FAIRFIELD, CA 94533-6066
- **Practice address phone:** (650) 454-6109
- **Practice address fax:** (650) 231-2633
- **Mailing address:** PO BOX 3082, REDWOOD CITY, CA 94064-3082
- **Mailing address phone:** (650) 454-6109
- **Mailing address fax:** (650) 231-2633

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 49566 | CA | Yes |

## Other

- **Enumeration date:** 04/18/2012
- **Last updated:** 04/18/2012