Provider Demographics
NPI:1730438532
Name:SCHILGI MAMOU, TAMAR (MA)
Entity type:Individual
Prefix:
First Name:TAMAR
Middle Name:
Last Name:SCHILGI MAMOU
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 S MARY AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3060
Mailing Address - Country:US
Mailing Address - Phone:408-209-4933
Mailing Address - Fax:
Practice Address - Street 1:1309 S MARY AVE STE 208
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3060
Practice Address - Country:US
Practice Address - Phone:408-209-4933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107120106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty