Healthcare Provider Details

I. General information

NPI: 1962028241
Provider Name (Legal Business Name): SAMANTHA LYNN TUMINARO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2020
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41870 GARSTIN DR
BIG BEAR LAKE CA
92315-2088
US

IV. Provider business mailing address

909 W RAINBOW BLVD
BIG BEAR CITY CA
92314-9386
US

V. Phone/Fax

Practice location:
  • Phone: 909-866-6501
  • Fax:
Mailing address:
  • Phone: 773-447-3969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: