# TAMMY FOGLE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1720436546
- **Gender:** F
- **Credential:** RN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 123352IV | CA | Yes |
| 163WG0000X | General Practice Registered Nurse | 555078 | CA | — |

## Other

- **Enumeration date:** 06/02/2016
- **Last updated:** 06/02/2016