Provider Demographics
NPI:1841419330
Name:MAGGIORE, TANYA DEBORAH (MFT)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:DEBORAH
Last Name:MAGGIORE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:DEBORAH
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:1911 WILLIAMS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2612
Mailing Address - Country:US
Mailing Address - Phone:805-477-5710
Mailing Address - Fax:805-644-2659
Practice Address - Street 1:1911 WILLIAMS DR
Practice Address - Street 2:SUITE 110
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2612
Practice Address - Country:US
Practice Address - Phone:805-981-4233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 35681106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist