Individual
MS. TAMMY ANN JAVONILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED PSYCH TECH
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT34326
CA
374700000X
Technician
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/08/2007
Last updated
06/09/2021
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