Provider Demographics
NPI:1649098237
Name:TAMANAHA, RAYCE
Entity type:Individual
Prefix:
First Name:RAYCE
Middle Name:
Last Name:TAMANAHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2066 W FALMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1751
Mailing Address - Country:US
Mailing Address - Phone:714-517-8941
Mailing Address - Fax:
Practice Address - Street 1:2066 W FALMOUTH AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1751
Practice Address - Country:US
Practice Address - Phone:714-517-8941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist