Provider Demographics
NPI:1689307779
Name:RATLEDGE, TAMBRA LAJOY (FNP-C)
Entity type:Individual
Prefix:
First Name:TAMBRA
Middle Name:LAJOY
Last Name:RATLEDGE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4249
Mailing Address - Country:US
Mailing Address - Phone:760-291-6700
Mailing Address - Fax:
Practice Address - Street 1:1035 S MAIN AVE
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3338
Practice Address - Country:US
Practice Address - Phone:760-291-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA739351163W00000X
CA95021665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse