Provider Demographics
NPI:1285774539
Name:THOROUGHGOOD, TANIA MENDOZA (LPC, LPCC)
Entity type:Individual
Prefix:MS
First Name:TANIA
Middle Name:MENDOZA
Last Name:THOROUGHGOOD
Suffix:
Gender:F
Credentials:LPC, LPCC
Other - Prefix:
Other - First Name:TANIA
Other - Middle Name:
Other - Last Name:MENDOZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:221 HOLLOWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-2309
Mailing Address - Country:US
Mailing Address - Phone:415-840-7849
Mailing Address - Fax:
Practice Address - Street 1:8931 HURON ST.
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260
Practice Address - Country:US
Practice Address - Phone:415-555-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4315101YP2500X
CA15942101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional