Provider Demographics
NPI:1851590996
Name:LOZANO, NIA TASHA (MD)
Entity Type:Individual
Prefix:DR
First Name:NIA
Middle Name:TASHA
Last Name:LOZANO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:228 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-4519
Mailing Address - Country:US
Mailing Address - Phone:707-553-5331
Mailing Address - Fax:707-553-5653
Practice Address - Street 1:228 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-4519
Practice Address - Country:US
Practice Address - Phone:707-553-5331
Practice Address - Fax:707-553-5653
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA892552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry