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NPI Code Detail

MEDICARE: PAUL JOSEPH TAMBINI LCSW

MEDICARE: PAUL JOSEPH TAMBINI LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
21041C0700XClinical Social Worker114633CA

General Provider Information

NPI Number : 1003353087
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL JOSEPH TAMBINI LCSW
Provider Business Mailing Address
First Line : PO BOX 1453
Second Line :
City : FOLSOM
State : CA
Zip : 95763-1453
Country : US
Telephone Number : 916-220-3831
Fax Number :
Provider Business Practice Location Address
First Line : 520 CHADBOURNE RD
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-9656
Country : US
Telephone Number : 707-366-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2017
Last Update Date : 04/04/2023

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