Provider Demographics
NPI:1528764529
Name:BARTHOLOW, TATE JAMES
Entity type:Individual
Prefix:
First Name:TATE
Middle Name:JAMES
Last Name:BARTHOLOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1381 WANDERER LN
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-8284
Mailing Address - Country:US
Mailing Address - Phone:707-494-5747
Mailing Address - Fax:
Practice Address - Street 1:1381 WANDERER LN
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-8284
Practice Address - Country:US
Practice Address - Phone:707-494-5747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health