Provider Demographics
NPI:1841956109
Name:HAYNES, TAMIA
Entity type:Individual
Prefix:
First Name:TAMIA
Middle Name:
Last Name:HAYNES
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 1:3440 ARMOURDALE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-3131
Mailing Address - Country:US
Mailing Address - Phone:562-441-3139
Mailing Address - Fax:407-650-2754
Practice Address - Street 1:13784 GOLDENWEST ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683
Practice Address - Country:US
Practice Address - Phone:714-760-9993
Practice Address - Fax:407-650-2754
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
0515OtherCLIENT INSURANCE