Provider Demographics
NPI:1487995924
Name:TUMBER, JUDY GARCIA (PA-C)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:GARCIA
Last Name:TUMBER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8727 WENTWORTH CT
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-6370
Mailing Address - Country:US
Mailing Address - Phone:916-749-3479
Mailing Address - Fax:
Practice Address - Street 1:8727 WENTWORTH CT
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-6370
Practice Address - Country:US
Practice Address - Phone:916-749-3479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16439363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant