Provider Demographics
NPI:1992142871
Name:SCHROEDER, TAMERA ELISE
Entity type:Individual
Prefix:
First Name:TAMERA
Middle Name:ELISE
Last Name:SCHROEDER
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 1:9172 REGENTS RD APT A
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1446
Mailing Address - Country:US
Mailing Address - Phone:512-608-1169
Mailing Address - Fax:
Practice Address - Street 1:9172 REGENTS RD APT A
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1446
Practice Address - Country:US
Practice Address - Phone:512-608-1169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN