Provider Demographics
NPI:1417681636
Name:FERIA MENDEZ, TANIA IVONEE (RBT)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:IVONEE
Last Name:FERIA MENDEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 THERESA AVE
Mailing Address - Street 2:
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-9654
Mailing Address - Country:US
Mailing Address - Phone:707-567-1446
Mailing Address - Fax:
Practice Address - Street 1:120 THERESA AVE
Practice Address - Street 2:
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-9654
Practice Address - Country:US
Practice Address - Phone:707-567-1446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician