Provider Demographics
NPI:1982296109
Name:VAUGHAN, TONJA LYNN (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:TONJA
Middle Name:LYNN
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13815 NAHUM DR APT B
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-6088
Mailing Address - Country:US
Mailing Address - Phone:760-993-0630
Mailing Address - Fax:
Practice Address - Street 1:13815 NAHUM DR APT B
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-6088
Practice Address - Country:US
Practice Address - Phone:760-993-0630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician