Provider Demographics
NPI:1699395202
Name:ATELIAN, TANYA M (CPT1)
Entity Type:Individual
Prefix:MISS
First Name:TANYA
Middle Name:M
Last Name:ATELIAN
Suffix:
Gender:F
Credentials:CPT1
Other - Prefix:MISS
Other - First Name:TANYA
Other - Middle Name:M
Other - Last Name:ATELIAN
Other - Suffix:X
Other - Last Name Type:Professional Name
Other - Credentials:CPT1
Mailing Address - Street 1:195 E MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-1025
Mailing Address - Country:US
Mailing Address - Phone:805-280-5218
Mailing Address - Fax:805-735-3636
Practice Address - Street 1:195 E MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-1025
Practice Address - Country:US
Practice Address - Phone:805-280-5218
Practice Address - Fax:805-735-3636
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT00024629246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty