Healthcare Provider Details

I. General information

NPI: 1992101497
Provider Name (Legal Business Name): TAMARA WEBER MFTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2014
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 59
SALIDA CA
95368-0059
US

IV. Provider business mailing address

PO BOX 59
SALIDA CA
95368-0059
US

V. Phone/Fax

Practice location:
  • Phone: 209-482-7854
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number105926
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: