Provider Demographics
NPI:1447791389
Name:HAUCK, TONIEKA DAVETTA
Entity Type:Individual
Prefix:
First Name:TONIEKA
Middle Name:DAVETTA
Last Name:HAUCK
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 1:43418 GADSDEN AVE APT 50
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-6151
Mailing Address - Country:US
Mailing Address - Phone:661-483-4761
Mailing Address - Fax:
Practice Address - Street 1:43418 GADSDEN AVE APT 50
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-6151
Practice Address - Country:US
Practice Address - Phone:661-483-4761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-11
Last Update Date:2017-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)