Provider Demographics
NPI:1346053998
Name:TASHIRO, NAYOMI CHAMPAGNE CALANGI
Entity type:Individual
Prefix:
First Name:NAYOMI CHAMPAGNE
Middle Name:CALANGI
Last Name:TASHIRO
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 1:4423 TWIN PEAKS CT
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-6168
Mailing Address - Country:US
Mailing Address - Phone:909-586-0100
Mailing Address - Fax:
Practice Address - Street 1:4423 TWIN PEAKS CT
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-6168
Practice Address - Country:US
Practice Address - Phone:909-586-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician