Individual
TAMARA GRANADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 BERCUT DR, SACRAMENTO, CA 95811-0131
(916) 440-1500
Mailing address
600 BERCUT DR, SACRAMENTO, CA 95811-0131
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
171R00000X
Interpreter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171M00000X
—
CA
Enumeration date
01/23/2019
Last updated
06/11/2019
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