Provider Demographics
NPI:1053864389
Name:COLSTON, TASHIANA
Entity Type:Individual
Prefix:
First Name:TASHIANA
Middle Name:
Last Name:COLSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21455 BIRCH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-2165
Mailing Address - Country:US
Mailing Address - Phone:510-844-5370
Mailing Address - Fax:510-583-0410
Practice Address - Street 1:21455 BIRCH ST STE 201
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-2165
Practice Address - Country:US
Practice Address - Phone:510-844-5370
Practice Address - Fax:510-583-0410
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical