Provider Demographics
NPI:1366121089
Name:ROSS-TOHILL, JONATHAN T (RADT)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:T
Last Name:ROSS-TOHILL
Suffix:
Gender:M
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 TUCKER RD STE G #216
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-2576
Mailing Address - Country:US
Mailing Address - Phone:719-246-6830
Mailing Address - Fax:
Practice Address - Street 1:410 W. J ST TEHACHAPI, CA 93561
Practice Address - Street 2:UNIT A
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561
Practice Address - Country:US
Practice Address - Phone:661-750-0438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1495880123101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)