Provider Demographics
NPI:1154485506
Name:CHASE, TANYA S (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:S
Last Name:CHASE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MARKET ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1513
Mailing Address - Country:US
Mailing Address - Phone:415-863-3883
Mailing Address - Fax:
Practice Address - Street 1:1111 MARKET ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1513
Practice Address - Country:US
Practice Address - Phone:415-863-3883
Practice Address - Fax:415-863-7343
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94020865103T00000X
101YA0400X
CAC608111303101YA0400X
CARPS 2012698101Y00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)