Active NPI
Teona Callaham Amble, PH.D.
- Clinical Psychologist
- Tacoma, WA
National Provider Identifier
1639593288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY61040124
- Practice address
- 2202 South Cedar St #300/#200
Tacoma, WA 98405 - Phone
- (253) 301-5280
- NPI assigned
- Feb 18, 2014
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY61040124 | WA | Primary |
Addresses
Primary practice location
2202 South Cedar St #300/#200
Tacoma, WA 98405
Mailing address
P.O. Box 5299
737-3-Pcon
Tacoma, WA 98415-0299
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY61040124 | WA | MD | Clinical Psychologist |
| 36225 | TX | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618531200000",
"number": "1639593288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 5299",
"address_2": "737-3-PCON",
"city": "TACOMA",
"state": "WA",
"postal_code": "984150299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2202 SOUTH CEDAR ST #300/#200",
"city": "TACOMA",
"state": "WA",
"postal_code": "98405",
"telephone_number": "253-301-5280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBLE",
"first_name": "TEONA",
"middle_name": "CALLAHAM",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-18",
"last_updated": "2021-04-16",
"certification_date": "2021-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY61040124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.