MEDICARE: TAWNY ANN DICKENS

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
1	106H00000X	Marriage & Family Therapist	158085	CA

General Provider Information

NPI Number	:	1134079478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAWNY ANN DICKENS

Provider Business Mailing Address
First Line	:	20409 YORBA LINDA BLVD STE K
Second Line	:	141
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3042
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20409 YORBA LINDA BLVD STE K
Second Line	:	141
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3042
Country	:	US
Telephone Number	:	714-406-4215
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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Directions to “ TAWNY ANN DICKENS ” Practice Location

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