Individual
MRS. TAMARA LAKISHA BOGAR TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
995 POTRERO AVE BLDG 90, SAN FRANCISCO, CA 94110-2859
(628) 206-8683
Mailing address
24471 BORREGO CIR, CORONA, CA 92883-5159
(951) 433-0990
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
689467
CA
Other
Enumeration date
03/02/2023
Last updated
03/02/2023
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