Provider Demographics
NPI:1407646565
Name:ROBINSON, TONYA LOUISE (REGISTER NURSE)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:LOUISE
Last Name:ROBINSON
Suffix:
Gender:
Credentials:REGISTER NURSE
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:LOUISE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3605 BELLWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-1743
Mailing Address - Country:US
Mailing Address - Phone:209-204-5841
Mailing Address - Fax:
Practice Address - Street 1:740 FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-3115
Practice Address - Country:US
Practice Address - Phone:209-204-5841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251X00000X
261QR0405X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251X00000XAgenciesSupports Brokerage
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder