Individual
DANIEL TENNENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1600 CALIFORNIA DR, VACAVILLE, CA 95687
(707) 449-6582
Mailing address
PO BOX 2000, VACAVILLE, CA 95696-2000
(707) 449-6582
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY12848
CA
Other
Enumeration date
03/24/2009
Last updated
03/24/2009
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