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NPI Code Detail

MEDICARE: MRS. TABITHA AMES CCCE, CLD, CPD, CLE

MEDICARE:  MRS. TABITHA  AMES  CCCE, CLD, CPD, CLE
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
1174400000XSpecialist

General Provider Information

NPI Number : 1306277983
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TABITHA AMES CCCE, CLD, CPD, CLE
Provider Business Mailing Address
First Line : 3748 MORNINGSIDE DR
Second Line :
City : RICHMOND
State : CA
Zip : 94803-2128
Country : US
Telephone Number : 925-360-0817
Fax Number :
Provider Business Practice Location Address
First Line : 3748 MORNINGSIDE DR
Second Line :
City : RICHMOND
State : CA
Zip : 94803-2128
Country : US
Telephone Number : 925-360-0817
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2013
Last Update Date : 12/06/2013

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Directions to “ MRS. TABITHA AMES CCCE, CLD, CPD, CLE” Practice Location

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