Individual
TAMARA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TAMARA
Contact information
Practice address
222 N SUNSET AVE STE D, WEST COVINA, CA 91790-2278
(652) 693-5449
Mailing address
222 N SUNSET AVE STE D, WEST COVINA, CA 91790-2278
(562) 693-5449
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9778
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9778
CALIFORNIA BOARD PHYSICAL THERAPY
CA
Enumeration date
07/16/2018
Last updated
07/16/2018
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