Provider Demographics
NPI:1053128082
Name:FERRARI, TAMARA LYNN (MSW, PPS)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LYNN
Last Name:FERRARI
Suffix:
Gender:F
Credentials:MSW, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10129 LAUREN WAY
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-1677
Mailing Address - Country:US
Mailing Address - Phone:619-252-1628
Mailing Address - Fax:
Practice Address - Street 1:11833 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:CA
Practice Address - Zip Code:92040-2911
Practice Address - Country:US
Practice Address - Phone:619-390-2636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health