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NPI Code Detail

MEDICARE: CASEY TAMANAHA

MEDICARE: CASEY TAMANAHA
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
1172V00000XCommunity Health Worker
2390200000XStudent in an Organized Health Care Education/Training Program
3104100000XSocial WorkerCA
41041C0700XClinical Social Worker134491CA

General Provider Information

NPI Number : 1538745930
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY TAMANAHA
Provider Business Mailing Address
First Line : 1907 BOYS REPUBLIC DR
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-5447
Country : US
Telephone Number : 909-628-1217
Fax Number : 909-306-5427
Provider Business Practice Location Address
First Line : 14505 KRAMER RANCH RD
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-5454
Country : US
Telephone Number : 909-740-3137
Fax Number : 909-306-5427
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2021
Last Update Date : 10/17/2025

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Directions to “ CASEY TAMANAHA ” Practice Location

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