MEDICARE: TAMARA JEAN CHAFFIN

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	171M00000X	Case Manager/Care Coordinator
2	1041C0700X	Clinical Social Worker	101224	CA
3	1041C0700X	Clinical Social Worker	LCSW101224	CA

General Provider Information

NPI Number	:	1386772408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA JEAN CHAFFIN

Provider Business Mailing Address
First Line	:	520 SCENIC DR
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93103-2925
Country	:	US
Telephone Number	:	661-747-1935
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 SCENIC DR
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93103-2925
Country	:	US
Telephone Number	:	661-747-1935
Fax Number	:

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	11/07/2024

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