Provider Demographics
NPI:1407181183
Name:DEPAEP, TABARE (ESQ, CD(CAPPA))
Entity Type:Individual
Prefix:MS
First Name:TABARE
Middle Name:
Last Name:DEPAEP
Suffix:
Gender:F
Credentials:ESQ, CD(CAPPA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-1833
Mailing Address - Country:US
Mailing Address - Phone:818-679-0947
Mailing Address - Fax:
Practice Address - Street 1:5125 E 3RD ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90814-1833
Practice Address - Country:US
Practice Address - Phone:818-679-0947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula