Provider Demographics
NPI:1841772258
Name:HUNTER, TAMI JO (RADT)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:JO
Last Name:HUNTER
Suffix:
Gender:F
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 N MORRISON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2749
Mailing Address - Country:US
Mailing Address - Phone:831-588-5871
Mailing Address - Fax:
Practice Address - Street 1:976 LENZEN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2737
Practice Address - Country:US
Practice Address - Phone:408-792-5656
Practice Address - Fax:408-947-8719
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1266760917101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)