Healthcare Provider Details

I. General information

NPI: 1144606088
Provider Name (Legal Business Name): TINAI JAMES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 BIRCH CREEK CIR
MCDONOUGH GA
30253-7258
US

IV. Provider business mailing address

285 BIRCH CREEK CIR
MCDONOUGH GA
30253-7258
US

V. Phone/Fax

Practice location:
  • Phone: 415-672-4353
  • Fax:
Mailing address:
  • Phone: 415-672-4353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY004598
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31750
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY004598
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY31750
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY004598
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY31750
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: