Andrew J Tamanaha | Rancho Cucamonga, CA • PECOS Search

Andrew J Tamanaha

Psychologist

Behavioral Health & Social Service Providers

9327 Fairway View Pl Ste 110, Rancho Cucamonga, CA 91730-0969

(099) 453-3309 (909) 425-7679

PECOS Enrollment

Based on the most recent information from CMS, provider Andrew J Tamanaha does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1841430113
Provider Type
Individual
Full Name
Tamanaha, Andrew J
Title
Dr.
Credential
PH.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
2/26/2009
Last Updated
11/7/2018

Contact Information

Practice Location

9327 Fairway View Pl Ste 110, Rancho Cucamonga, CA 91730-0969

(909) 945-1031

Mailing Location

3102 E. Highland Avenue, Medical Staff Office, Patton, CA 92369

(909) 425-6635

Provider Taxonomies

Code	Description	License
Code 103T00000X Primary	Description Psychologist Behavioral Health & Social Service Providers	License PSY21662 California