Provider Demographics
NPI:1669546412
Name:GULBRANSON, TONYA KATE (LCSW)
Entity type:Individual
Prefix:MS
First Name:TONYA
Middle Name:KATE
Last Name:GULBRANSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TONYA
Other - Middle Name:KATE
Other - Last Name:STRAUGHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LCSW-C
Mailing Address - Street 1:3555 WHIPPLE RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-1507
Mailing Address - Country:US
Mailing Address - Phone:510-675-4832
Mailing Address - Fax:
Practice Address - Street 1:3555 WHIPPLE RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1507
Practice Address - Country:US
Practice Address - Phone:510-675-4832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS232981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical