Provider Demographics
NPI:1528931250
Name:MORENO PARMITER, TAWNYA LYNN
Entity type:Individual
Prefix:
First Name:TAWNYA
Middle Name:LYNN
Last Name:MORENO PARMITER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAWNYA
Other - Middle Name:LYNN
Other - Last Name:POHLMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2525 E 104TH AVE UNIT 1117
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-6184
Mailing Address - Country:US
Mailing Address - Phone:720-853-7307
Mailing Address - Fax:
Practice Address - Street 1:1200 CONCORD AVE STE 185
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5006
Practice Address - Country:US
Practice Address - Phone:650-648-4170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty