Basic Information
| Provider Information | |||||||||
| NPI: | 1093450694 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CATALANO | ||||||||
| FirstName: | TAMMI | ||||||||
| MiddleName: | JOY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 29002 LAKE RIDGE LN | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923463903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099100385 | ||||||||
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| Practice Location | |||||||||
| Address1: | 26001 REDLANDS BLVD | ||||||||
| Address2: | |||||||||
| City: | REDLANDS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923737762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098257084 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2022 | ||||||||
| LastUpdateDate: | 04/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XM0800X | 4813 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Mental Health |
No ID Information.