Provider Demographics
NPI:1548302078
Name:ACKERMAN, TAMARA DAWN TREBILCOCK (ND)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:DAWN TREBILCOCK
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:689 W FOOTHILL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3400
Mailing Address - Country:US
Mailing Address - Phone:310-526-7328
Mailing Address - Fax:310-651-8684
Practice Address - Street 1:689 W FOOTHILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711
Practice Address - Country:US
Practice Address - Phone:310-526-7328
Practice Address - Fax:310-651-8684
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-146175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath