Most Relevant Information
Provider Data
| NPI Number: | 1003633660 |
| Provider Name: | TYNA NGO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/24/2024 |
| Last Updated: | 09/24/2024 |
Provider Practice Location
2450 MARTIN RD STE 100
FAIRFIELD
CA
945341018
Practice Location Phone/Fax
| Phone: | 8552237123 |
| Fax: |
Provider Mailing Location
PO BOX 33568
SAN DIEGO
CA
921633568
Provider Mailing Phone/Fax
| Phone: | 8552237123 |
| Fax: |