Provider Demographics
NPI:1528744612
Name:CHRISTENSON, TANYA SHEREE
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:SHEREE
Last Name:CHRISTENSON
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 1:2280 DIAMOND BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5719
Mailing Address - Country:US
Mailing Address - Phone:925-483-2223
Mailing Address - Fax:
Practice Address - Street 1:2280 DIAMOND BLVD STE 500
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5719
Practice Address - Country:US
Practice Address - Phone:925-483-2223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker