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 3 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