Provider Demographics
NPI:1922411396
Name:GRABRECK, TAMMY (PHD)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:
Last Name:GRABRECK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 TEHAMA ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1681
Mailing Address - Country:US
Mailing Address - Phone:530-710-1070
Mailing Address - Fax:
Practice Address - Street 1:1640 TEHAMA ST
Practice Address - Street 2:SUITE C
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1681
Practice Address - Country:US
Practice Address - Phone:530-710-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2014-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 26823103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist