Provider Demographics
NPI:1174484802
Name:DORSO, TAMARA (POSTPARTUM DOULA)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:DORSO
Suffix:
Gender:F
Credentials:POSTPARTUM DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3514 GONDAR AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-2812
Mailing Address - Country:US
Mailing Address - Phone:916-300-7394
Mailing Address - Fax:
Practice Address - Street 1:3514 GONDAR AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-2812
Practice Address - Country:US
Practice Address - Phone:916-300-7394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-21
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty