Provider Demographics
NPI:1609008671
Name:XIONG-THAO, TAO (ACSW)
Entity Type:Individual
Prefix:MRS
First Name:TAO
Middle Name:
Last Name:XIONG-THAO
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CAMERON DR
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-3581
Mailing Address - Country:US
Mailing Address - Phone:530-534-7245
Mailing Address - Fax:
Practice Address - Street 1:865 MITCHELL AVE
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-4646
Practice Address - Country:US
Practice Address - Phone:530-538-7950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23837101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health