Provider Demographics
NPI:1740302579
Name:PADGETT, TONDA CHERI
Entity type:Individual
Prefix:
First Name:TONDA
Middle Name:CHERI
Last Name:PADGETT
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 1:11035 SIERRA TREE LN
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-2306
Mailing Address - Country:US
Mailing Address - Phone:909-520-7675
Mailing Address - Fax:
Practice Address - Street 1:TELECARE CORPORATION
Practice Address - Street 2:431 MCKAY DRIVE
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3222
Practice Address - Country:US
Practice Address - Phone:909-433-9300
Practice Address - Fax:909-433-9308
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)