Provider Demographics
NPI:1952706863
Name:DELANEY, TAMARA BETH
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:BETH
Last Name:DELANEY
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 1:1825 MORTON AVE
Mailing Address - Street 2:APT 306
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-1879
Mailing Address - Country:US
Mailing Address - Phone:805-338-7505
Mailing Address - Fax:
Practice Address - Street 1:1825 MORTON AVE
Practice Address - Street 2:APT 306
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-1879
Practice Address - Country:US
Practice Address - Phone:805-338-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13924225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics