Provider Demographics
NPI:1912678749
Name:CHESTNUT, TAWNY LYNN (MA PPSC AMFT)
Entity Type:Individual
Prefix:MRS
First Name:TAWNY
Middle Name:LYNN
Last Name:CHESTNUT
Suffix:
Gender:F
Credentials:MA PPSC AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 KENDAL ST STE B
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-3960
Mailing Address - Country:US
Mailing Address - Phone:707-330-7904
Mailing Address - Fax:
Practice Address - Street 1:313 KENDAL ST STE B
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-3960
Practice Address - Country:US
Practice Address - Phone:707-330-7904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist