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NPI Code Detail

MEDICARE: TANYA R MARK

MEDICARE: TANYA R MARK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1373H00000XDay Training/Habilitation SpecialistCA

General Provider Information

NPI Number : 1033049721
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANYA R MARK
Provider Business Mailing Address
First Line : 3665 SNOWCAP VIEW CIR APT 4
Second Line :
City : AUBURN
State : CA
Zip : 95602-2179
Country : US
Telephone Number : 916-287-5870
Fax Number :
Provider Business Practice Location Address
First Line : 1430 BLUE OAKS BLVD STE 260
Second Line :
City : ROSEVILLE
State : CA
Zip : 95747-4003
Country : US
Telephone Number : 530-887-1006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2026
Last Update Date : 05/22/2026

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Directions to “ TANYA R MARK ” Practice Location

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