Provider Demographics
NPI:1740944107
Name:BONDS, TYSEAN DIERRE (CASE MANAGER)
Entity type:Individual
Prefix:MR
First Name:TYSEAN
Middle Name:DIERRE
Last Name:BONDS
Suffix:
Gender:M
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 3RD ST BLDG 1
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-1443
Mailing Address - Country:US
Mailing Address - Phone:510-473-7416
Mailing Address - Fax:
Practice Address - Street 1:3450 ST BLDG. 1 UNIT 1C
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124
Practice Address - Country:US
Practice Address - Phone:510-473-7416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-22
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker