Provider Demographics
NPI:1992097232
Name:LEEPER, TAMARA M (CD(DONA))
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:M
Last Name:LEEPER
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 LINDEN AVE APT 31
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-5031
Mailing Address - Country:US
Mailing Address - Phone:714-235-6105
Mailing Address - Fax:562-435-1140
Practice Address - Street 1:65 LINDEN AVE APT 31
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-5031
Practice Address - Country:US
Practice Address - Phone:714-235-6105
Practice Address - Fax:562-435-1140
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula