Provider Demographics
NPI:1487867107
Name:PIPKIN, TAMARA L (RTEI)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:L
Last Name:PIPKIN
Suffix:
Gender:F
Credentials:RTEI
Other - Prefix:
Other - First Name:TAMMIE
Other - Middle Name:L
Other - Last Name:PIPKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RTEI
Mailing Address - Street 1:5616 SHAMROCK RD
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-9796
Mailing Address - Country:US
Mailing Address - Phone:530-340-0233
Mailing Address - Fax:
Practice Address - Street 1:1515 S OREGON ST
Practice Address - Street 2:SUITE A
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-3425
Practice Address - Country:US
Practice Address - Phone:530-842-3455
Practice Address - Fax:530-842-7917
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker