Provider Demographics
NPI:1457142473
Name:BROOKS, TIANA UNIQUE MARIE
Entity type:Individual
Prefix:
First Name:TIANA
Middle Name:UNIQUE MARIE
Last Name:BROOKS
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 1:7011 SUNNE LN APT 340
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3627
Mailing Address - Country:US
Mailing Address - Phone:415-573-5193
Mailing Address - Fax:
Practice Address - Street 1:7011 SUNNE LN APT 340
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-3627
Practice Address - Country:US
Practice Address - Phone:415-573-5193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician