Provider Demographics
NPI:1043441165
Name:MAGINOT-CHESHER, TAMARA R (PHD)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:R
Last Name:MAGINOT-CHESHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:TAMARA
Other - Middle Name:R
Other - Last Name:MAGINOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 232410
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-2410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103
Practice Address - Country:US
Practice Address - Phone:858-534-7792
Practice Address - Fax:619-471-9017
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28678103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical