Provider Demographics
NPI:1568585107
Name:TOBIAS, TIMOTHY LAHR (ASW)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LAHR
Last Name:TOBIAS
Suffix:
Gender:M
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 N COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-2585
Mailing Address - Country:US
Mailing Address - Phone:916-375-6350
Mailing Address - Fax:
Practice Address - Street 1:14 N COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-2585
Practice Address - Country:US
Practice Address - Phone:916-375-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA150231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical