Tanesha Larae Atwell

Individual provider Active NPI Rehabilitation Practitioner · Yucca Valley, CA

NPI 1033459474 · NPPES record last updated Feb 21, 2013

Key facts

NPI
1033459474
Entity type
Individual (NPI type 1)
Primary specialty
Rehabilitation Practitioner 225400000X
Practice address
58945 Business Center Dr
Yucca Valley, CA 92284-7307
Phone
(760) 228-9657
NPI assigned
Feb 21, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Yes

Addresses

Primary practice location

58945 Business Center Dr
Yucca Valley, CA 92284-7307

Mailing address

58945 Business Center Dr
Yucca Valley, CA 92284-7307
Phone (760) 228-9657

Other providers in Yucca Valley, CA

All providers in Yucca Valley, CA · Rehabilitation Practitioner in California

Sources for this page

Verify at the official NPI Registry.