Provider Demographics
NPI:1477701241
Name:TARBILL, TIMOTHY H
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:H
Last Name:TARBILL
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 1:236 GEORGIA ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-5991
Mailing Address - Country:US
Mailing Address - Phone:510-290-5662
Mailing Address - Fax:707-654-8677
Practice Address - Street 1:236 GEORGIA ST
Practice Address - Street 2:SUITE 101
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5991
Practice Address - Country:US
Practice Address - Phone:510-290-5662
Practice Address - Fax:707-654-8677
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health