Provider Demographics
NPI:1235289463
Name:EICHELBERGER, TAMARA (PHD, PT)
Entity Type:Individual
Prefix:PROF
First Name:TAMARA
Middle Name:
Last Name:EICHELBERGER
Suffix:
Gender:F
Credentials:PHD, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 MIRAMONTE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2413
Mailing Address - Country:US
Mailing Address - Phone:650-965-7469
Mailing Address - Fax:
Practice Address - Street 1:10080 N WOLFE RD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2515
Practice Address - Country:US
Practice Address - Phone:408-342-6600
Practice Address - Fax:408-342-6655
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29950225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist