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General NPI Number Information
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NPI Number | 1639711435
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Entity Type | Individual
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Provider Name | MARIA ISABEL TAMAYO
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Gender | Female
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Dates
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Enumeration Date | 10/13/2019
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 255 N D ST. SUITE #412, 408
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City | SAN BERNARDINO
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State | CA
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Zip | 92401-1735
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Country | US
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Telephone | 951-788-5905
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Fax | 951-788-5903
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Provider Business Mailing Address
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Address Line | PO BOX 53413
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City | IRVINE
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State | CA
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Zip | 92619-3413
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Country | US
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Telephone | 657-236-1287
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Fax | 714-333-4535
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1117508
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License Number State | CA
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