Individual
DR. BETH COOPER TABAKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
412 RED HILL AVE, SUITE #6, SAN ANSELMO, CA 94960-2450
(415) 459-7707
Mailing address
PO BOX 823, FOREST KNOLLS, CA 94933-0823
(415) 488-9108
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY13580
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY13580
CALIF LIC
CA
Enumeration date
04/14/2007
Last updated
10/24/2011
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