MEDICARE: NORMA LISA TAMEZ CASE MANAGER

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1750500716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORMA LISA TAMEZ CASE MANAGER

Provider Business Mailing Address
First Line	:	252 S SACRAMENTO ST
Second Line	:
City	:	TULARE
State	:	CA
Zip	:	93274-3532
Country	:	US
Telephone Number	:	559-687-7046
Fax Number	:

Provider Business Practice Location Address
First Line	:	252 S SACRAMENTO ST
Second Line	:
City	:	TULARE
State	:	CA
Zip	:	93274-3532
Country	:	US
Telephone Number	:	559-687-7046
Fax Number	:	559-781-0032

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

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	10/28/2021

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