Provider Demographics
NPI:1336242411
Name:TAMMARIELLO, CHRIS FRANK (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:FRANK
Last Name:TAMMARIELLO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1788
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92018-1788
Mailing Address - Country:US
Mailing Address - Phone:760-434-5003
Mailing Address - Fax:
Practice Address - Street 1:2755 JEFFERSON STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008
Practice Address - Country:US
Practice Address - Phone:760-434-5003
Practice Address - Fax:760-434-5104
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS195441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical