Provider Demographics
NPI:1366411886
Name:TAHAN, MARGARET DENISE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:DENISE
Last Name:TAHAN
Suffix:
Gender:F
Credentials:LCSW
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 73221
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95617-3221
Mailing Address - Country:US
Mailing Address - Phone:916-366-5427
Mailing Address - Fax:916-366-5441
Practice Address - Street 1:10633 GRISSOM AVE
Practice Address - Street 2:
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655-4123
Practice Address - Country:US
Practice Address - Phone:916-366-5427
Practice Address - Fax:916-366-5441
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS200591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical