Provider Demographics
NPI:1558438044
Name:BREWER, TANYA MAY (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:MAY
Last Name:BREWER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 PAMELA JANE CT
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-5224
Mailing Address - Country:US
Mailing Address - Phone:530-789-3911
Mailing Address - Fax:
Practice Address - Street 1:2218 5TH AVE
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-5816
Practice Address - Country:US
Practice Address - Phone:530-433-4622
Practice Address - Fax:530-789-3911
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013804363LP0808X
167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Not Answered167G00000XNursing Service ProvidersLicensed Psychiatric Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VN193426OtherNURSING LICENSE