Provider Demographics
NPI:1366063158
Name:BACHECKI, TAMMI R (RN)
Entity type:Individual
Prefix:
First Name:TAMMI
Middle Name:R
Last Name:BACHECKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 CANNON DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2233
Mailing Address - Country:US
Mailing Address - Phone:925-890-0907
Mailing Address - Fax:
Practice Address - Street 1:1890 CANNON DR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-2233
Practice Address - Country:US
Practice Address - Phone:925-890-0907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-03
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA614776163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine