Provider Demographics
NPI:1962634147
Name:RAMAGE, TAMI RAE (MFT)
Entity Type:Individual
Prefix:MS
First Name:TAMI
Middle Name:RAE
Last Name:RAMAGE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 E SHAW AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7918
Mailing Address - Country:US
Mailing Address - Phone:559-226-1316
Mailing Address - Fax:
Practice Address - Street 1:1322 E SHAW AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7918
Practice Address - Country:US
Practice Address - Phone:559-226-1316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50455106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist