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Contact Information

KEITH J TANENBAUM, LCSW
924 EMERALD BAY RD
FIRST FLOOR
SOUTH LAKE TAHOE, CA96150
 Phone: 530-782-9889
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Hospice and Palliative Medicine

2084H0002X 17 Physician/Hospice and Palliative Care
 

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for KEITH J TANENBAUM · (Male)

NPI # 1477169605
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 09/22/2020
Last updated 10/05/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 107074
  • CA License # 107974
  • CA License # 89589
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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