Provider Demographics
NPI:1528607306
Name:PAONE, TAMI (NP)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:
Last Name:PAONE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 WEST LA VETA AVE.
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4203
Mailing Address - Country:US
Mailing Address - Phone:714-997-3000
Mailing Address - Fax:855-246-2329
Practice Address - Street 1:1201 WEST LA VETA AVE.
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4203
Practice Address - Country:US
Practice Address - Phone:714-997-3000
Practice Address - Fax:855-246-2329
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-27
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013075363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily