Provider Demographics
NPI:1669838975
Name:AMALANI-JOUBERT, TAREVA (BHT)
Entity Type:Individual
Prefix:
First Name:TAREVA
Middle Name:
Last Name:AMALANI-JOUBERT
Suffix:
Gender:F
Credentials:BHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 N COUNTRY CLUB DR
Mailing Address - Street 2:BUIDLING # 1
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-4108
Mailing Address - Country:US
Mailing Address - Phone:480-969-3800
Mailing Address - Fax:480-307-9771
Practice Address - Street 1:422 W IVYGLEN ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-2107
Practice Address - Country:US
Practice Address - Phone:480-969-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other