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General NPI Number Information
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NPI Number | 1356130645
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Entity Type | Individual
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Provider Name | MS. TANYA BAKER
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Gender | Female
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 333 ESTUDILLO AVE STE 201
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City | SAN LEANDRO
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State | CA
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Zip | 94577-4717
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Country | US
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Telephone | 510-221-6233
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Fax |
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Provider Business Mailing Address
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Address Line | 225 LASSEN DR
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City | SAN BRUNO
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State | CA
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Zip | 94066-2517
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Country | US
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Telephone | 510-967-4271
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | CA
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