Provider Demographics
NPI:1801207444
Name:BEARD, TIANA (LMFT)
Entity type:Individual
Prefix:MRS
First Name:TIANA
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:TIANA
Other - Middle Name:
Other - Last Name:TOWNSEND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2415 SAN PABLO DAM RD STE 106-270
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3919
Mailing Address - Country:US
Mailing Address - Phone:510-859-4704
Mailing Address - Fax:
Practice Address - Street 1:3150 HILLTOP MALL RD STE 12
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-1921
Practice Address - Country:US
Practice Address - Phone:510-859-4704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-16
Last Update Date:2019-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104023106H00000X
390200000X
CAIMF 92474101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program