Provider Demographics
NPI:1417572520
Name:JAMES, TAMARA GAYE (RN)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:GAYE
Last Name:JAMES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1767 SUNSET CLIFFS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-3217
Mailing Address - Country:US
Mailing Address - Phone:619-279-1309
Mailing Address - Fax:
Practice Address - Street 1:1767 SUNSET CLIFFS BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-3217
Practice Address - Country:US
Practice Address - Phone:619-279-1309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN375294163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse