Provider Demographics
NPI:1639720071
Name:EARNHART, TAMATHA K (LMFT, ATR)
Entity Type:Individual
Prefix:
First Name:TAMATHA
Middle Name:K
Last Name:EARNHART
Suffix:
Gender:F
Credentials:LMFT, ATR
Other - Prefix:
Other - First Name:TAMI
Other - Middle Name:
Other - Last Name:EARNHART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 231096
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92023-1096
Mailing Address - Country:US
Mailing Address - Phone:760-456-9362
Mailing Address - Fax:
Practice Address - Street 1:365 S RANCHO SANTA FE RD STE 204
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2338
Practice Address - Country:US
Practice Address - Phone:760-456-9362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95728106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist