Provider Demographics
NPI:1215256011
Name:HARRIS, TAMMI LORRAINE (NP)
Entity type:Individual
Prefix:
First Name:TAMMI
Middle Name:LORRAINE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4911 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1716
Mailing Address - Country:US
Mailing Address - Phone:818-981-7111
Mailing Address - Fax:
Practice Address - Street 1:9233 W PICO BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1386
Practice Address - Country:US
Practice Address - Phone:310-356-8146
Practice Address - Fax:818-356-8142
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2016-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA14292363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology