Provider Demographics
NPI:1992997662
Name:JOHNSTON, TAMRA LYNN (MS)
Entity type:Individual
Prefix:
First Name:TAMRA
Middle Name:LYNN
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:TAMI
Other - Middle Name:
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:1054 W TOWN AND COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4716
Mailing Address - Country:US
Mailing Address - Phone:714-796-2576
Mailing Address - Fax:714-796-1254
Practice Address - Street 1:1054 W TOWN AND COUNTRY RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4716
Practice Address - Country:US
Practice Address - Phone:714-796-2576
Practice Address - Fax:714-796-1254
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS