Provider Demographics
NPI:1215264692
Name:TATE, TARA (LMFT)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:TATE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 REDCLIFF DR STE 225
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0102
Mailing Address - Country:US
Mailing Address - Phone:530-515-9155
Mailing Address - Fax:
Practice Address - Street 1:429 REDCLIFF DR STE 225
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0102
Practice Address - Country:US
Practice Address - Phone:530-515-9155
Practice Address - Fax:530-515-9155
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61612106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist