Provider Demographics
NPI:1235873076
Name:SHIH, TAMARA (PT, MPT)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:SHIH
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5519 GOLD CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-5442
Mailing Address - Country:US
Mailing Address - Phone:510-459-8450
Mailing Address - Fax:
Practice Address - Street 1:2355 SAN RAMON VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1523
Practice Address - Country:US
Practice Address - Phone:925-322-0713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27290225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist