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General NPI Number Information
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NPI Number | 1003737255
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Entity Type | Individual
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Provider Name | DEJA TATMAN
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Gender | Female
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 1111 W TOKAY ST
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City | LODI
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State | CA
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Zip | 95240-3965
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Country | US
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Telephone | 925-999-4119
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Fax |
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Provider Business Mailing Address
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Address Line | 6937 SUMTER QUAY CIR
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City | STOCKTON
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State | CA
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Zip | 95219-3152
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Country | US
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Telephone | 925-878-3286
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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