Individual
MS. TAMMY ANN JAVONILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED PSYCH TECH
Contact information
Practice address
2600 REDONDO AVE, LONG BEACH, CA 90806-2325
(562) 256-2900
(562) 290-0074
Mailing address
2600 REDONDO AVE, LONG BEACH, CA 90806-2325
(562) 256-2900
(562) 290-0074
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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