Provider Demographics
NPI:1891224598
Name:HILL RODRIGUEZ, TANYA
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:HILL RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W FRANKLIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2725
Mailing Address - Country:US
Mailing Address - Phone:916-337-4052
Mailing Address - Fax:800-991-6071
Practice Address - Street 1:7340 GOLDEN SAGE DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79911-3115
Practice Address - Country:US
Practice Address - Phone:915-245-7249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician