Provider Demographics
NPI:1467998096
Name:TONNESEN, STEVEN SCOTT
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:SCOTT
Last Name:TONNESEN
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 1:30 ANGELICA WAY
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037
Mailing Address - Country:US
Mailing Address - Phone:669-262-7466
Mailing Address - Fax:
Practice Address - Street 1:30 ANGELICA WAY
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2723
Practice Address - Country:US
Practice Address - Phone:669-262-7466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF83426201223S0112X, 146D00000X, 1835P1300X, 246X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist Cardiovascular
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA92438530G46315Medicaid