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General NPI Number Information
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NPI Number | 1336969633
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Entity Type | Individual
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Provider Name | MISS VICTORIA A TAMAYO
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Gender | Female
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Dates
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Enumeration Date | 10/12/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 201 ALAMEDA DEL PRADO
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City | NOVATO
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State | CA
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Zip | 94949-6688
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Country | US
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Telephone | 415-720-0313
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Fax |
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Provider Business Mailing Address
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Address Line | 1116 3RD ST APT 3
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City | NOVATO
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State | CA
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Zip | 94945-2336
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Country | US
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Telephone | 415-845-6110
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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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