Healthcare Provider Details

I. General information

NPI: 1083480628
Provider Name (Legal Business Name): TAMELA LYNN DUNN PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5222 PIRRONE CT STE 101A
SALIDA CA
95368-9072
US

IV. Provider business mailing address

5222 PIRRONE CT STE 101A
SALIDA CA
95368-9072
US

V. Phone/Fax

Practice location:
  • Phone: 925-282-1778
  • Fax: 415-296-5299
Mailing address:
  • Phone: 925-282-1778
  • Fax: 415-296-5299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95028131
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: