Healthcare Provider Details

I. General information

NPI: 1053112441
Provider Name (Legal Business Name): TAMARA N AMEND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 TOWN CENTER DR # 410
OXNARD CA
93036-1100
US

IV. Provider business mailing address

6234 GITANA AVE
CAMARILLO CA
93012-8127
US

V. Phone/Fax

Practice location:
  • Phone: 805-586-1152
  • Fax:
Mailing address:
  • Phone: 424-425-4501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: