1013731249 NPI number — MRS. BEATRIZ RAMONA TLAHUITZO-DELAO RADT-1, MHFA

Table of content: MRS. BEATRIZ RAMONA TLAHUITZO-DELAO RADT-1, MHFA (NPI 1013731249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013731249 NPI number — MRS. BEATRIZ RAMONA TLAHUITZO-DELAO RADT-1, MHFA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TLAHUITZO-DELAO
Provider First Name:
BEATRIZ
Provider Middle Name:
RAMONA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RADT-1, MHFA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORALES-DELAO
Provider Other First Name:
BEATRIZ
Provider Other Middle Name:
RAMONA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1013731249
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8843 OAKFIELD LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINDSOR
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95492-8401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-495-2357
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1430 NEOTOMAS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA ROSA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95405-7575
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-565-7450
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  R1566280724 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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