Provider Demographics
NPI:1700031903
Name:JAMES, TAMARA SUE (RN CDE)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:SUE
Last Name:JAMES
Suffix:
Gender:F
Credentials:RN CDE
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:SUE
Other - Last Name:TRIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4860 Y ST
Mailing Address - Street 2:0400
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-4306
Mailing Address - Fax:916-734-0759
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:0400
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-4306
Practice Address - Fax:916-734-0759
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA09910332174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist