Healthcare Provider Details

I. General information

NPI: 1053534768
Provider Name (Legal Business Name): TAMMY CHRISTINE CARTER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 HOSPITAL WAY
MATHER CA
95655-4200
US

IV. Provider business mailing address

3645 WINGS WAY STE 110
NORTH HIGHLANDS CA
95660-4958
US

V. Phone/Fax

Practice location:
  • Phone: 916-843-7000
  • Fax:
Mailing address:
  • Phone: 916-893-0015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number24635
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: