Most Relevant Information
Provider Data
| NPI Number: | 1003027772 |
| Provider Name: | TANYA MCCULLOM |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/24/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
7200 BANCROFT AVE
SUITE 125D
OAKLAND
CA
946052403
Practice Location Phone/Fax
| Phone: | 5107773886 |
| Fax: | 5107773880 |
Provider Mailing Location
7200 BANCROFT AVE
SUITE 125D
OAKLAND
CA
946052403
Provider Mailing Phone/Fax
| Phone: | 5107773886 |
| Fax: | 5107773880 |