Basic Information
| Provider Information | |||||||||
| NPI: | 1962011312 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMSEY | ||||||||
| FirstName: | TARAH | ||||||||
| MiddleName: | ELENA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6C SCARLETT RD | ||||||||
| Address2: | |||||||||
| City: | CARMEL VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939249437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314024910 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1900 GARDEN RD STE 280 | ||||||||
| Address2: | |||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939405374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8312200739 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2020 | ||||||||
| LastUpdateDate: | 03/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | RBT-20-130935 | FL | Y |
No ID Information.