MARY ELLEN TANNER (NPI# 1063767796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063767796 |
| Entity Type | Individual |
| Full Name | MARY ELLEN TANNER |
| Credential | LCSW |
| Practice Address |
4740 N Grand Ave Covina CA 91724-2005 |
| Practice Telephone | 6268592089 |
| Practice Fax Number | 6268596537 |
| Mailing Telephone | 6268592089 |
| Mailing Fax Number | 6268596537 |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2016-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW73551 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639583420 | Mary Beth Tanner | Occupational Therapist | 1907 Refinery Rd, Gainesville, TX 76240-2111 | 2014-06-19 |
| 1538590641 | Mary Therese Tanner | Social Worker | 1251 Nilles Rd Ste 5, Fairfield, OH 45014-7205 | 2013-11-29 |
| 1174751549 | Mary Tanner | Pediatrics | 1600 Clifton Rd Ne, Atlanta, GA 30329 | 2009-06-24 |
| Street Address |
4740 N GRAND AVE |
| City | COVINA |
| State | CA |
| Zip Code | 91724-2005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205979960 | Roxana Maselli | Rehabilitation Practitioner | 4740 N Grand Ave, Covina, CA 91724-2005 | 2007-02-14 |
| 1093312266 | Elsa Elizalde | Rehabilitation Practitioner | 4740 N Grand Ave, Covina, CA 91724-2005 | 2020-10-01 |
| 1790382950 | Brandon Funes | Rehabilitation Practitioner | 4740 N Grand Ave, Covina, CA 91724-2005 | 2020-10-01 |
| 1013567999 | Sandra Hernandez-chavez | Counselor | 4740 N Grand Ave, Covina, CA 91724-2005 | 2019-09-12 |
| 1144879370 | Ismael L. Ramirez | Licensed Psychiatric Technician | 4740 N Grand Ave, Covina, CA 91724-2005 | 2019-09-10 |
| 1750849295 | Sylvia Arias | Licensed Psychiatric Technician | 4740 N Grand Ave, Covina, CA 91724-2005 | 2019-03-04 |
| 1912475997 | Erika R Ozuna | Rehabilitation Practitioner | 4740 N Grand Ave, Covina, CA 91724-2005 | 2018-11-07 |
| 1528536760 | Diandra Elise La Croix | Counselor | 4740 N Grand Ave, Covina, CA 91724-2005 | 2018-11-06 |
| 1780164061 | Gabrielle N Kubulan | Counselor | 4740 N Grand Ave, Covina, CA 91724-2005 | 2018-08-16 |
| 1215415096 | Jennifer K Flores | Rehabilitation Practitioner | 4740 N Grand Ave, Covina, CA 91724 | 2018-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902320922 | Kimberly Suzanne Manzanares-mora | Rehabilitation Practitioner | 1359 North Grand Avenue, Covina, CA 91724 | 2017-08-01 |
| 1689194680 | Cynthia Garcia | Counselor | 1359 N. Grand Ave., Covina, CA 91724 | 2017-06-21 |
| 1386191963 | West Covina Group Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1274 Center Court Dr, #208, Covina, CA 91724 | 2016-09-01 |
| 1184094781 | Veronica May Roberts | Licensed Vocational Nurse | 222 S. Wilson Ave, Covina, CA 91724 | 2015-09-25 |
| 1912216292 | Joan Mendoza | Social Worker | 1338 Center Court Dr Ste 107, Covina, CA 91724 | 2010-10-04 |
| 1548583602 | Lille-anne Nzeribe | Rehabilitation Practitioner | 1126 N. Grand Ave. Suite D, Covina, CA 91724 | 2010-03-03 |
| 1154534212 | Verna L Lewis | Marriage & Family Therapist | 420 South Grand Ave., Covina, CA 91724 | 2007-05-07 |
| 1093937310 | Heather Annn Pedevillano | Specialist/Technologist | 1805 E. Lomira Dr, Covina, CA 91724 | 2007-05-03 |
| 1669503579 | Maritza Mercedes Reyes | Rehabilitation Practitioner | 1411 N. Grand Ave., Covina, CA 91724 | 2007-03-09 |
| 1417014085 | Bernadette Luyun Guaring Bagay | Dentist | 984 E Badillo St, Suite E, Covina, CA 91724 | 2007-01-03 |
| Find all providers in zip 91724 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154836906 | Martha G. Calderon | Social Worker | 599 S Barranca Ave Ste 208, Covina, CA 91723-2785 | 2017-12-01 |
| 1477915320 | Juanita Thompson | Social Worker | 560 E Rowland St, Covina, CA 91723-3210 | 2016-03-21 |
| 1912216292 | Joan Mendoza | Social Worker | 1338 Center Court Dr Ste 107, Covina, CA 91724 | 2010-10-04 |
| 1336468776 | Cynthia Chang Daley | Social Worker | 750 Terrado Plz Ste 122, Covina, CA 91723-3411 | 2010-05-25 |
| 1598992406 | Margaret Duenez | Social Worker | 969 S Village Oaks Dr Ste 201, Covina, CA 91724-0606 | 2009-06-18 |
| 1316196066 | Carrie A Chung | Social Worker | 125 W Center St, Covina, Covina, CA 91723-2637 | 2008-09-17 |
| 1356536023 | Cheryl Epler | Social Worker | 20517 E Calora St, Covina, CA 91724-1240 | 2007-09-06 |
| 1972700367 | Delia Margarita Garcia Montoya | Social Worker | 19553 E Puente St, Covina, CA 91724-3269 | 2007-06-28 |
| 1215153473 | Natalia Salinas | Social Worker | 128 N Citrus Ave Ste D, Covina, CA 91723-2039 | 2007-04-17 |
| 1669502142 | Serenity Infant Care Homes | Social Worker | 600 S Grand Ave, Covina, CA 91724-3638 | 2007-03-06 |
| Find all providers in COVINA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.