Provider Demographics
NPI:1194311464
Name:DANTUS, TANYA (MA, LMFT)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:DANTUS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 LADERA SARINA
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-4230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BURGACKERWEG 10B
Practice Address - Street 2:
Practice Address - City:FREIBURG
Practice Address - State:BADEN-WRTTEMBERG
Practice Address - Zip Code:79104
Practice Address - Country:DE
Practice Address - Phone:858-480-7685
Practice Address - Fax:573-368-0067
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120399106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist