Provider Demographics
NPI:1013349216
Name:CRABB, TANYA SIMONE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:SIMONE
Last Name:CRABB
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:TANYA
Other - Middle Name:SIMONE
Other - Last Name:HIBBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1911 BLUE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-2703
Mailing Address - Country:US
Mailing Address - Phone:559-213-2786
Mailing Address - Fax:
Practice Address - Street 1:FAMILY COURT LIAISON BRANCH
Practice Address - Street 2:42-470 KALANIAOLE HWY., COTTAGE 3
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734
Practice Address - Country:US
Practice Address - Phone:808-266-9922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60890986103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist