Individual
TRACEY BOLDEMANN-TATKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, AMFT
Contact information
Practice address
28632 ROADSIDE DR STE 143, AGOURA HILLS, CA 91301-6072
(818) 300-7826
Mailing address
28632 ROADSIDE DR STE 143, AGOURA HILLS, CA 91301-6072
(818) 300-7826
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
AMFT151968
CA
Other
Enumeration date
10/28/2025
Last updated
10/28/2025
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