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Pamela A. Tait

Marriage & Family Therapist

Behavioral Health & Social Service Providers

1314 Westwood Blvd, Suite 206, Los Angeles, CA 90024-4928

PECOS Enrollment

This provider is enrolled in PECOS as PAMELA TAIT.

Based on the most recent information from CMS, provider Pamela A. Tait is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1639408438
Provider Type
Individual
Full Name
Tait, Pamela A.
Title
Ms.
Credential
M.F.T.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
12/8/2009
Last Updated
12/8/2009

Contact Information

Practice Location

1314 Westwood Blvd, Suite 206, Los Angeles, CA 90024-4928

(310) 712-5434

Unlisted Fax

Mailing Location

1314 Westwood Blvd, Suite 206, Los Angeles, CA 90024-4928

(310) 712-5434

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License MFT39012 California

Pamela A. Tait

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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