Provider Demographics
NPI:1518797539
Name:GREGORY, TAMBER
Entity type:Individual
Prefix:
First Name:TAMBER
Middle Name:
Last Name:GREGORY
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 1:7040 AVENIDA ENCINAS STE 103
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-4653
Mailing Address - Country:US
Mailing Address - Phone:760-405-8275
Mailing Address - Fax:760-405-8276
Practice Address - Street 1:7040 AVENIDA ENCINAS STE 103
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-4653
Practice Address - Country:US
Practice Address - Phone:760-405-8275
Practice Address - Fax:760-405-8276
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10736237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist