Provider Demographics
NPI:1013947571
Name:TAMAR, LAYA M (MSW)
Entity Type:Individual
Prefix:
First Name:LAYA
Middle Name:M
Last Name:TAMAR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30497 CANWOOD ST
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4330
Mailing Address - Country:US
Mailing Address - Phone:805-496-2455
Mailing Address - Fax:805-496-9981
Practice Address - Street 1:30497 CANWOOD ST
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4330
Practice Address - Country:US
Practice Address - Phone:805-496-2455
Practice Address - Fax:805-496-9981
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS199941041C0700X
CO9860301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR19954Medicare UPIN