JACK S. TANENBAUM

LODI, CA
NPI1154419505
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: CA  LCS 1098)
Enumeration Date2006-10-11
Last Update Date2010-10-01
Business Address
Mr. JACK S. TANENBAUM lcsw
1920 TIENDA DR STE 101
LODI, CA 95242-3930
Phone number: 916-662-5947
Mailing Address
Mr. JACK S. TANENBAUM lcsw
2715 W KETTLEMAN LN STE 203-113
LODI, CA 95242-9289
Phone number: 916-662-5947
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