Provider Demographics
NPI:1699196485
Name:TANIYA SWEENEY
Entity Type:Organization
Organization Name:TANIYA SWEENEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BASIC SKILLS WORKER
Authorized Official - Prefix:
Authorized Official - First Name:TANIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-722-5878
Mailing Address - Street 1:413 SOUTH B STRRET
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570
Mailing Address - Country:US
Mailing Address - Phone:951-722-5878
Mailing Address - Fax:
Practice Address - Street 1:413 SOUTH B STRRET
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570
Practice Address - Country:US
Practice Address - Phone:951-722-5878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health