Provider Demographics
NPI:1083990766
Name:HAHN, TAMARA JEAN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:JEAN
Last Name:HAHN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1642 GRANITE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-2607
Mailing Address - Country:US
Mailing Address - Phone:619-201-2954
Mailing Address - Fax:
Practice Address - Street 1:250 E CHASE AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-6305
Practice Address - Country:US
Practice Address - Phone:619-647-6157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3675225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist