Provider Demographics
NPI:1568620342
Name:HORN, TA'SHANNE WATU
Entity Type:Individual
Prefix:
First Name:TA'SHANNE
Middle Name:WATU
Last Name:HORN
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:PO BOX 8959
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-8959
Mailing Address - Country:US
Mailing Address - Phone:530-815-4328
Mailing Address - Fax:530-636-4772
Practice Address - Street 1:572 RIO LINDO AVE STE 203
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1851
Practice Address - Country:US
Practice Address - Phone:530-815-4328
Practice Address - Fax:530-636-4772
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW893131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical