Provider Demographics
NPI:1104383678
Name:HERRERO, TONIA NALEEN (MPS, ATR-BC, LCAT)
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:NALEEN
Last Name:HERRERO
Suffix:
Gender:F
Credentials:MPS, ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 SANTA CLARA AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-1375
Mailing Address - Country:US
Mailing Address - Phone:510-675-7070
Mailing Address - Fax:
Practice Address - Street 1:55 SANTA CLARA AVE STE 220
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-1375
Practice Address - Country:US
Practice Address - Phone:510-675-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-20
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
18-101221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist