Provider Demographics
NPI:1285954008
Name:TAMKIN, MARTIN HOWARD (LMFT)
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:HOWARD
Last Name:TAMKIN
Suffix:
Gender:M
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:PO BOX 987
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80201-0987
Mailing Address - Country:US
Mailing Address - Phone:323-251-5592
Mailing Address - Fax:323-927-1857
Practice Address - Street 1:130 S EUCLID AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2446
Practice Address - Country:US
Practice Address - Phone:323-251-5592
Practice Address - Fax:323-927-1857
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44861106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist