Provider Demographics
NPI:1306277983
Name:AMES, TABITHA (CCCE, CLD, CPD, CLE)
Entity type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:
Last Name:AMES
Suffix:
Gender:F
Credentials:CCCE, CLD, CPD, CLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3748 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94803-2128
Mailing Address - Country:US
Mailing Address - Phone:925-360-0817
Mailing Address - Fax:
Practice Address - Street 1:3748 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94803-2128
Practice Address - Country:US
Practice Address - Phone:925-360-0817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist