Provider Demographics
NPI:1992441059
Name:FARRIS, TAMMY LEE (CERTIFIED DOULA)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LEE
Last Name:FARRIS
Suffix:
Gender:F
Credentials:CERTIFIED DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8317 STONYBECK CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828-6647
Mailing Address - Country:US
Mailing Address - Phone:760-579-8476
Mailing Address - Fax:
Practice Address - Street 1:8317 STONYBECK CIR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-6647
Practice Address - Country:US
Practice Address - Phone:760-579-8476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula