Provider Demographics
NPI:1386479178
Name:CASSEY, TAMAA JOSEPH (APCC)
Entity type:Individual
Prefix:MR
First Name:TAMAA
Middle Name:JOSEPH
Last Name:CASSEY
Suffix:
Gender:M
Credentials:APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N HOWARD ST STE R
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0508
Mailing Address - Country:US
Mailing Address - Phone:323-895-5902
Mailing Address - Fax:
Practice Address - Street 1:9700 EL CAMINO REAL STE 200
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-5579
Practice Address - Country:US
Practice Address - Phone:805-460-7300
Practice Address - Fax:805-468-4290
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17321101YM0800X
WAMC61635058101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health