Individual
MS. LYNNE TAMARA TAVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.N.P.
Contact information
Practice address
1750 EL CAMINO REAL STE 11, BURLINGAME, CA 94010-3208
(650) 692-1373
(650) 692-4209
Mailing address
1750 EL CAMINO REAL STE 11, BURLINGAME, CA 94010-3208
(650) 692-1373
(650) 692-4209
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
13288
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ71317Z
—
CA
Enumeration date
02/08/2007
Last updated
07/08/2007
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