Healthcare Provider Details

I. General information

NPI: 1609289545
Provider Name (Legal Business Name): JAMIE TALLMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 CAMINO DEL REMEDIO
SANTA BARBARA CA
93110
US

IV. Provider business mailing address

8248 QUARTZ ST
VENTURA CA
93004
US

V. Phone/Fax

Practice location:
  • Phone: 805-681-5244
  • Fax:
Mailing address:
  • Phone: 805-732-5221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number779577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: