Healthcare Provider Details

I. General information

NPI: 1982924007
Provider Name (Legal Business Name): MRS. TAMERA ZEFPHRINE LANDRUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. TAMERA ZEFPHRINE EDWARDS

II. Dates (important events)

Enumeration Date: 06/11/2010
Last Update Date: 06/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44443 10TH ST W
LANCASTER CA
93534-3346
US

IV. Provider business mailing address

44443 10TH ST W
LANCASTER CA
93534-3346
US

V. Phone/Fax

Practice location:
  • Phone: 661-726-2630
  • Fax: 661-952-1030
Mailing address:
  • Phone: 661-726-2630
  • Fax: 661-952-1030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberN/A
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: