Active NPI
Tamara L Phelan, P. T.
- Physical Therapist
- Stockton, CA
National Provider Identifier
1306908181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 26988
- Practice address
- 3215 N California St
Suite 4
Stockton, CA 95204-3433 - Phone
- (209) 464-6016
- Fax
- (209) 464-6017
- NPI assigned
- Dec 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 26988 | CA | Primary |
Addresses
Primary practice location
3215 N California St
Suite 4
Stockton, CA 95204-3433
Mailing address
PO Box 4904
Stockton, CA 95204-0904
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325635200000",
"number": "1306908181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4904",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952040904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3215 N CALIFORNIA ST",
"address_2": "SUITE 4",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952043433",
"telephone_number": "209-464-6016",
"fax_number": "209-464-6017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHELAN",
"first_name": "TAMARA",
"middle_name": "L",
"credential": "P. T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-15",
"last_updated": "2012-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "26988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.