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General NPI Number Information
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NPI Number | 1962710954
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Entity Type | Organization
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Legal Business Name | TAMMY ELKINS, PHD
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 802 14TH ST STE G
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City | MODESTO
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State | CA
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Zip | 95354-1029
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Country | US
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Telephone | 209-521-4334
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Fax |
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Provider Business Mailing Address
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Address Line | 802 14TH ST STE G
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City | MODESTO
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State | CA
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Zip | 95354-1029
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Country | US
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Telephone | 209-521-4334
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | TAMMY ELKINS
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Credential | PHD
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Telephone | 209-985-4162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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