Provider Demographics
NPI:1679673347
Name:WINCHELL, TAMMY ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:ANN
Last Name:WINCHELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:ANN
Other - Last Name:HERSCHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:750 REDWOOD HWY FRONTAGE RD STE 1204
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2483
Practice Address - Country:US
Practice Address - Phone:415-384-4778
Practice Address - Fax:415-384-4779
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007401363LP0200X
OR201150050NP363LP0200X
CANP95000700363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics