Healthcare Provider Details

I. General information

NPI: 1740054899
Provider Name (Legal Business Name): TAMADE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 11/09/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 LOMA VISTA ST
PASADENA CA
91104-3904
US

IV. Provider business mailing address

1800 LOMA VISTA ST
PASADENA CA
91104-3904
US

V. Phone/Fax

Practice location:
  • Phone: 323-545-3659
  • Fax:
Mailing address:
  • Phone: 323-545-3659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CELINE TIEN
Title or Position: CEO
Credential:
Phone: 760-889-1132