Individual
AMY L TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5222 PIRRONE CT STE 101A, SALIDA, CA 95368-9072
(925) 282-1778
Mailing address
5222 PIRRONE CT STE 101A, SALIDA, CA 95368-9072
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
26063
CA
Other
Enumeration date
01/11/2014
Last updated
04/24/2025
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