Provider Demographics
NPI:1013731249
Name:TLAHUITZO-DELAO, BEATRIZ RAMONA (RADT-1, MHFA)
Entity type:Individual
Prefix:MRS
First Name:BEATRIZ
Middle Name:RAMONA
Last Name:TLAHUITZO-DELAO
Suffix:
Gender:F
Credentials:RADT-1, MHFA
Other - Prefix:MRS
Other - First Name:BEATRIZ
Other - Middle Name:RAMONA
Other - Last Name:MORALES-DELAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8843 OAKFIELD LN
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-8401
Mailing Address - Country:US
Mailing Address - Phone:707-495-2357
Mailing Address - Fax:
Practice Address - Street 1:1430 NEOTOMAS AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-7575
Practice Address - Country:US
Practice Address - Phone:707-565-7450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1566280724101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)