Provider Demographics
NPI:1952191389
Name:ADLER, TONY ROSE
Entity type:Individual
Prefix:
First Name:TONY
Middle Name:ROSE
Last Name:ADLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 EARL JOSEPH DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-7832
Mailing Address - Country:US
Mailing Address - Phone:818-859-4672
Mailing Address - Fax:
Practice Address - Street 1:691 EARL JOSEPH DR
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-7832
Practice Address - Country:US
Practice Address - Phone:818-859-4672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health