Healthcare Provider Details

I. General information

NPI: 1710779996
Provider Name (Legal Business Name): TAMARA CHAMBERLAIN CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4254 34TH ST
SAN DIEGO CA
92104-1415
US

IV. Provider business mailing address

4254 34TH ST
SAN DIEGO CA
92104-1415
US

V. Phone/Fax

Practice location:
  • Phone: 720-245-5984
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number1475726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: