Provider Demographics
NPI:1063420115
Name:DRUMGOLE, TANJULA (MFT)
Entity type:Individual
Prefix:MS
First Name:TANJULA
Middle Name:
Last Name:DRUMGOLE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-0485
Mailing Address - Country:US
Mailing Address - Phone:951-594-0693
Mailing Address - Fax:
Practice Address - Street 1:41690 ENTERPRISE CIR N STE 226
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5660
Practice Address - Country:US
Practice Address - Phone:951-594-0693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT48706106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist