Provider Demographics
NPI:1306177852
Name:TAMANE, GAURI DEVENDRA
Entity type:Individual
Prefix:
First Name:GAURI
Middle Name:DEVENDRA
Last Name:TAMANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20504 VENTURA BLVD
Mailing Address - Street 2:APT #311
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-6210
Mailing Address - Country:US
Mailing Address - Phone:626-755-4218
Mailing Address - Fax:
Practice Address - Street 1:433 N 4TH ST
Practice Address - Street 2:SUITE #101
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4311
Practice Address - Country:US
Practice Address - Phone:323-722-8610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15933235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist