Provider Demographics
NPI:1841423092
Name:TAPP, TERA
Entity Type:Individual
Prefix:
First Name:TERA
Middle Name:
Last Name:TAPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9719 LINCOLN VILLAGE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-3328
Mailing Address - Country:US
Mailing Address - Phone:916-362-8292
Mailing Address - Fax:916-362-8295
Practice Address - Street 1:9211 GERBER RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95829-1130
Practice Address - Country:US
Practice Address - Phone:916-423-1157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator