Provider Demographics
NPI:1497964860
Name:THAMM, VALERY ALAYN EVON
Entity Type:Individual
Prefix:MS
First Name:VALERY
Middle Name:ALAYN EVON
Last Name:THAMM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 MARKET ST
Mailing Address - Street 2:736
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-6999
Mailing Address - Country:US
Mailing Address - Phone:612-481-0063
Mailing Address - Fax:
Practice Address - Street 1:303 MARKET ST
Practice Address - Street 2:736
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-6999
Practice Address - Country:US
Practice Address - Phone:612-481-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA1367224Z00000X
FLOTA10201224Z00000X
MN201378224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant