Provider Demographics
NPI:1053572248
Name:HARBUCK-WARD, TAMARA LYNN (MHAI)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LYNN
Last Name:HARBUCK-WARD
Suffix:
Gender:F
Credentials:MHAI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LORETTO DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3512
Mailing Address - Country:US
Mailing Address - Phone:916-736-6727
Mailing Address - Fax:916-736-2470
Practice Address - Street 1:5450 POWER INN RD. STE. B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-6749
Practice Address - Country:US
Practice Address - Phone:916-388-9418
Practice Address - Fax:916-388-9273
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor