Healthcare Provider Details

I. General information

NPI: 1083523385
Provider Name (Legal Business Name): TIA AYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 S GOLD ST
YREKA CA
96097-3110
US

IV. Provider business mailing address

9413 ORO FINO RD
FORT JONES CA
96032-9709
US

V. Phone/Fax

Practice location:
  • Phone: 530-646-8513
  • Fax:
Mailing address:
  • Phone: 530-646-8513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number83DC314D8C
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: