Provider Demographics
NPI:1972229219
Name:TANYA WARD FAMILY PSYCHOTHERAPY CORPORATION
Entity Type:Organization
Organization Name:TANYA WARD FAMILY PSYCHOTHERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-308-9364
Mailing Address - Street 1:4716 E FAIRFIELD ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3650
Mailing Address - Country:US
Mailing Address - Phone:714-308-9364
Mailing Address - Fax:
Practice Address - Street 1:265 S RANDOLPH AVE STE 250
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5701
Practice Address - Country:US
Practice Address - Phone:714-308-9364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty