Organization
KIMBERLY TANGEN PHD, LICENSED PSYCHOLOGIST, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY ANNE TANGEN PHD QME (CEO)
(323) 538-4779
Entity
Organization
Contact information
Practice address
4519 ADMIRALTY WAY STE 110, MARINA DEL REY, CA 90292-5455
(323) 538-4779
(323) 817-1150
Mailing address
8117 W MANCHESTER AVE # 885, PLAYA DEL REY, CA 90293-8211
(323) 538-4779
(323) 817-1150
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 22865
CA
Other
Enumeration date
08/16/2016
Last updated
12/02/2016
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