MEDICARE: TAMARA SUE OWENS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	776248	CA

General Provider Information

NPI Number	:	1013847250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA SUE OWENS RN

Provider Business Mailing Address
First Line	:	929 BRIDGE ST
Second Line	:
City	:	COLUSA
State	:	CA
Zip	:	95932-2899
Country	:	US
Telephone Number	:	530-458-0689
Fax Number	:	530-458-2665

Provider Business Practice Location Address
First Line	:	929 BRIDGE ST
Second Line	:
City	:	COLUSA
State	:	CA
Zip	:	95932-2899
Country	:	US
Telephone Number	:	530-458-0689
Fax Number	:	530-458-2665

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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