Provider Demographics
NPI:1639205321
Name:HER, TIMOTHY C
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:C
Last Name:HER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TOUA
Other - Middle Name:
Other - Last Name:HER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:930 G ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-1802
Mailing Address - Country:US
Mailing Address - Phone:916-441-2933
Mailing Address - Fax:916-441-6896
Practice Address - Street 1:930 G ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-1802
Practice Address - Country:US
Practice Address - Phone:916-441-2933
Practice Address - Fax:916-441-6896
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator