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General NPI Number Information
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NPI Number | 1174401582
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Entity Type | Individual
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Provider Name | TAMERA SCOTT SUTHERLAND
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Gender | Female
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 765 N MAIN ST STE 127
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City | CORONA
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State | CA
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Zip | 92878-1440
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Country | US
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Telephone | 951-216-3549
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Fax |
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Provider Business Mailing Address
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Address Line | 24529 ROUND MEADOW DR
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City | MENIFEE
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State | CA
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Zip | 92584-2683
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Country | US
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Telephone | 619-788-7000
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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