Provider Demographics
NPI:1497416325
Name:COVEY, TANIA MICHELLE
Entity Type:Individual
Prefix:MS
First Name:TANIA
Middle Name:MICHELLE
Last Name:COVEY
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 1:336 RODGERS ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5207
Mailing Address - Country:US
Mailing Address - Phone:805-850-5997
Mailing Address - Fax:805-855-6020
Practice Address - Street 1:336 RODGERS ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5207
Practice Address - Country:US
Practice Address - Phone:805-850-5997
Practice Address - Fax:805-855-6020
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT0021548246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory