Provider Demographics
NPI:1699074203
Name:YADAO, TONY
Entity type:Individual
Prefix:MR
First Name:TONY
Middle Name:
Last Name:YADAO
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 1:2143 HURLEY WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-3299
Mailing Address - Country:US
Mailing Address - Phone:916-922-5110
Mailing Address - Fax:916-922-5124
Practice Address - Street 1:2143 HURLEY WAY STE 101
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3299
Practice Address - Country:US
Practice Address - Phone:916-922-5110
Practice Address - Fax:916-922-5124
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)