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NPI Code Detail

MEDICARE: MRS. BRANDI MICHELLE TUCKER

MEDICARE: MRS. BRANDI MICHELLE TUCKER
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1871616946
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRANDI MICHELLE TUCKER
Provider Business Mailing Address
First Line : 7840 ORCHARD WOODS CIR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95828-6204
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 855 HOWE AVE STE 1
Second Line :
City : SACRAMENTO
State : CA
Zip : 95825-3912
Country : US
Telephone Number : 916-929-0808
Fax Number : 916-649-8657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. BRANDI MICHELLE TUCKER ” Practice Location

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