Provider Demographics
NPI:1780380659
Name:ULRICH, TAMRIN (RDHAP)
Entity type:Individual
Prefix:
First Name:TAMRIN
Middle Name:
Last Name:ULRICH
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 HIBISCUS CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5567
Mailing Address - Country:US
Mailing Address - Phone:925-642-1361
Mailing Address - Fax:
Practice Address - Street 1:605 HIBISCUS CT
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-5567
Practice Address - Country:US
Practice Address - Phone:925-642-1361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA945124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist