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1891088704 NPI number — TARA LAUREN TARANTINO D.O.

NPI Number: 1891088704
Health Care Provider/Practitioner: TARA LAUREN TARANTINO D.O.

Information about “1891088704” NPI (TARA LAUREN TARANTINO D.O.) exists in 1891088704 in HTML format HTML  |  1891088704 in plain Text format TXT  |  1891088704 in PDF (Portable Document Format) PDF  |  1891088704 in an XML format XML  formats.

NPI Number : 1891088704 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1891088704",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TARANTINO",
    "FirstName": "TARA",
    "MiddleName": "LAUREN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "D.O.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SCHLEIFER",
    "OtherFirstName": "TARA",
    "OtherMiddleName": "LAUREN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "D.O.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "120 LA CASA VIA STE 106",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WALNUT CREEK",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94598-3092",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "925-448-2610",
    "MailingAddressFaxNumber": "925-448-2611",
    "FirstLinePracticeLocationAddress": "120 LA CASA VIA STE 106",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WALNUT CREEK",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94598-3092",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "925-448-2610",
    "PracticeLocationAddressFaxNumber": "925-319-6253",
    "EnumerationDate": "05/25/2011",
    "LastUpdateDate": "07/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "20A13976",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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