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NPI Code Detail

MEDICARE: MRS. RAKSMEY TIANO PHD

MEDICARE: MRS. RAKSMEY TIANO PHD
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
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor
3172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1649440280
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RAKSMEY TIANO PHD
Provider Business Mailing Address
First Line : 4545 GEORGETOWN PL
Second Line :
City : STOCKTON
State : CA
Zip : 95207-6215
Country : US
Telephone Number : 209-479-5429
Fax Number :
Provider Business Practice Location Address
First Line : 4545 GEORGETOWN PL STE A3
Second Line :
City : STOCKTON
State : CA
Zip : 95207-6228
Country : US
Telephone Number : 209-479-5429
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2008
Last Update Date : 01/12/2024

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