Provider Demographics
NPI:1063905586
Name:MASON, TAJIRI (CNA)
Entity type:Individual
Prefix:
First Name:TAJIRI
Middle Name:
Last Name:MASON
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 FOXGLOVE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-3754
Mailing Address - Country:US
Mailing Address - Phone:925-597-8493
Mailing Address - Fax:
Practice Address - Street 1:379 FOXGLOVE ST
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-3754
Practice Address - Country:US
Practice Address - Phone:925-597-8493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-09
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst