BROOKE ALYSE TANNENBAUM NPI 1275003642

NPI Information

  • NPI: 1275003642
  • Provider Name: BROOKE ALYSE TANNENBAUM
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 480 ALTA RD
    SAN DIEGO, CA
    ZIP 92179
  • Phone: (619) 661-6500

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NPI Details

Brooke Alyse Tannenbaum is a mental health counselor in San Diego, CA. Brooke Alyse Tannenbaum NPI is 1275003642. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

480 ALTA RD
SAN DIEGO, CA
ZIP 92179-001
Phone: (619) 661-6500

The enumeration date for this NPI number is 11/28/2018 and was last updated on 9/24/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1171M00000XCase Manager/Care CoordinatorNo
2101YM0800XCounselorMental Health17261CALIFORNIAYes
3103K00000XBehavior AnalystNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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