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General NPI Number Information
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NPI Number | 1497453609
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Entity Type | Individual
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Provider Name | JAMIE F TACTAY
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Gender | Female
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Dates
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Enumeration Date | 02/16/2023
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 3343 CAPITAL CENTER DR STE 200
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-7370
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Country | US
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Telephone | 510-618-5990
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Fax |
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Provider Business Mailing Address
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Address Line | 300 PULLMAN ST
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City | LIVERMORE
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State | CA
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Zip | 94551-9756
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Country | US
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Telephone | 916-509-1684
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT118789
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License Number State | CA
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