Provider Demographics
NPI:1285899765
Name:TAMANO, EMILY ANN (MFT-I)
Entity type:Individual
Prefix:MS
First Name:EMILY ANN
Middle Name:
Last Name:TAMANO
Suffix:
Gender:F
Credentials:MFT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25828 JUNIPER ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2506
Mailing Address - Country:US
Mailing Address - Phone:909-799-8016
Mailing Address - Fax:
Practice Address - Street 1:25828 JUNIPER ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2506
Practice Address - Country:US
Practice Address - Phone:909-799-8016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57174106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist