Provider Demographics
NPI:1336640796
Name:HATCHETT, TANYA TABADA TAGAY
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:TABADA TAGAY
Last Name:HATCHETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40479 TORENIA CIR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-5253
Mailing Address - Country:US
Mailing Address - Phone:510-241-7411
Mailing Address - Fax:
Practice Address - Street 1:260 EDMONDS ROAD
Practice Address - Street 2:BUILDING C
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062
Practice Address - Country:US
Practice Address - Phone:650-373-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health