Provider Demographics
NPI:1023883683
Name:LERMAN, TYLER MICAH
Entity type:Individual
Prefix:MR
First Name:TYLER
Middle Name:MICAH
Last Name:LERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 THEO LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3334
Mailing Address - Country:US
Mailing Address - Phone:925-270-6304
Mailing Address - Fax:
Practice Address - Street 1:160 THEO LN
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3334
Practice Address - Country:US
Practice Address - Phone:925-270-6304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician