Healthcare Provider Details

I. General information

NPI: 1316169022
Provider Name (Legal Business Name): TONYA LATHROP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 02/03/2020
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1965 LIVE OAK BLVD
YUBA CITY CA
95991-8850
US

IV. Provider business mailing address

1921 BUCHANAN ST
MARYSVILLE CA
95901-3817
US

V. Phone/Fax

Practice location:
  • Phone: 530-822-7200
  • Fax: 530-822-5061
Mailing address:
  • Phone: 530-271-1140
  • Fax: 530-271-7036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: