MEDICARE: TAMI BETH KENNEDY NP

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
1	363LW0102X	Women's Health Nurse Practitioner	15402	CA

General Provider Information

NPI Number	:	1861596942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMI BETH KENNEDY NP

Provider Business Mailing Address
First Line	:	26691 PLAZA STE 200
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-8582
Country	:	US
Telephone Number	:	949-998-2299
Fax Number	:	949-449-8458

Provider Business Practice Location Address
First Line	:	26691 PLAZA STE 200
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-8582
Country	:	US
Telephone Number	:	949-998-2299
Fax Number	:	949-449-8458

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	04/06/2026

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Directions to “ TAMI BETH KENNEDY NP” Practice Location

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