Individual
TASHUA CORUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 ADELINE ST, BERKELEY, CA 94703-2407
(510) 601-0203
Mailing address
3200 ADELINE ST, BERKELEY, CA 94703-2407
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
CA
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
04/21/2015
Last updated
06/10/2025
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