Individual
BROOKE ALYSE TANNENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
480 ALTA RD, SAN DIEGO, CA 92179-0001
(619) 661-6500
Mailing address
886 SUNNY BROOK WAY, PLEASANTON, CA 94566-3818
(925) 354-9870
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
17261
CA
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/28/2018
Last updated
09/24/2024
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