| Doctor Name: | TAMRA STAGER |
| NPI Number: | 1023408408 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | A10960614 |
| Business Practice Address: | 1818 Gilbreth Rd Ste 230 Burlingame, CA - 940101217 |
| Business Phone Number: | 6503486603 |
| Business Fax Number: | 6506522440 |
| Mailing Address: | 1818 Gilbreth Rd Ste 230, BURLINGAME |
| State: | CA |
| Postal Code: | 940101217 |
| Phone Number: | 6503486603 |
| Fax Number: | 6506522440 |
| NPI Enumeration Date: | 01/23/2015 |
| NPI Last Update Date: | 01/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | A10960614 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |