Provider Demographics
NPI:1578456398
Name:LASH, TAMI L (BSN, RN, PHN, SNSC)
Entity type:Individual
Prefix:MRS
First Name:TAMI
Middle Name:L
Last Name:LASH
Suffix:
Gender:F
Credentials:BSN, RN, PHN, SNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 MCBROOM AVE
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-5537
Mailing Address - Country:US
Mailing Address - Phone:760-987-8549
Mailing Address - Fax:
Practice Address - Street 1:35320 DAGGETT YERMO RD
Practice Address - Street 2:
Practice Address - City:YERMO
Practice Address - State:CA
Practice Address - Zip Code:92398-0408
Practice Address - Country:US
Practice Address - Phone:760-254-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA747481163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse