Healthcare Provider Details

I. General information

NPI: 1407471691
Provider Name (Legal Business Name): CARLING PAIGE TANNO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3671 BUSINESS DR STE 110
SACRAMENTO CA
95820-2233
US

IV. Provider business mailing address

3671 BUSINESS DR STE 110
SACRAMENTO CA
95820-2233
US

V. Phone/Fax

Practice location:
  • Phone: 916-732-8966
  • Fax:
Mailing address:
  • Phone: 916-732-8966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number36398
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: