Provider Demographics
NPI:1548395973
Name:VASSER, TAMIKA JO (BS PSY)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:JO
Last Name:VASSER
Suffix:
Gender:F
Credentials:BS PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3635 RUFFIN RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1880
Mailing Address - Country:US
Mailing Address - Phone:858-300-0460
Mailing Address - Fax:
Practice Address - Street 1:3635 RUFFIN RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1880
Practice Address - Country:US
Practice Address - Phone:858-300-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9992OtherMENTAL HEALTH CASE MGMNT