Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003090325 |
---|---|
Provider Name | Tamara Lynn Rianda |
First Address | Camarillo, CA 93012-8704 |
Second Address | Camarillo, CA 93012-8704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2007 |
Last Update Date | 25/03/2010 |