Provider Demographics
NPI:1740319763
Name:BROOKS, TONYA (LM)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14140 MAGNOLIA BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-1184
Mailing Address - Country:US
Mailing Address - Phone:818-386-1082
Mailing Address - Fax:818-386-9374
Practice Address - Street 1:14140 MAGNOLIA BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-1184
Practice Address - Country:US
Practice Address - Phone:818-386-1082
Practice Address - Fax:818-386-9374
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM0019176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife