Provider Demographics
NPI:1952655953
Name:MAZARIEGO, TAMIKA CHERYL
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:CHERYL
Last Name:MAZARIEGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMIKA
Other - Middle Name:CHERYL
Other - Last Name:TOWLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:650 HAMPSHIRE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VLG
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2534
Mailing Address - Country:US
Mailing Address - Phone:805-794-8522
Mailing Address - Fax:
Practice Address - Street 1:650 HAMPSHIRE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE VLG
Practice Address - State:CA
Practice Address - Zip Code:91361-2510
Practice Address - Country:US
Practice Address - Phone:805-794-8522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health