Basic Information
| Provider Information | |||||||||
| NPI: | 1003014382 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TONKIN | ||||||||
| FirstName: | LORI | ||||||||
| MiddleName: | JO | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4335 NAPIER ST | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921103447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607216748 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4010 VIA SERRA | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920576445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607577166 | ||||||||
| FaxNumber: | 7604335001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.