Provider Demographics
NPI:1629951686
Name:TANYA SHTUTMAN PSYCHOTHERAPY
Entity type:Organization
Organization Name:TANYA SHTUTMAN PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TATYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUZNETS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:530-902-5085
Mailing Address - Street 1:19312 GREENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3461
Mailing Address - Country:US
Mailing Address - Phone:530-902-5085
Mailing Address - Fax:
Practice Address - Street 1:19312 GREENWOOD CIR
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3461
Practice Address - Country:US
Practice Address - Phone:530-902-5085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)