Provider Demographics
NPI:1093867186
Name:TATE, JASON
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:TATE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 MIRA LOMA DR STE 10
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-3582
Mailing Address - Country:US
Mailing Address - Phone:530-538-0148
Mailing Address - Fax:
Practice Address - Street 1:205 MIRA LOMA DR STE 10
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-3582
Practice Address - Country:US
Practice Address - Phone:530-538-0148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor