Tillis, Travon Di Angelo
Tillis, Travon Di Angelo is an individual health care provider with primary practice located at 625 Fair Oaks Ave 300, South Pasadena CA 91030-2630. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Tillis, Travon Di Angelo can be contacted via phone (626) 395-7100.Contact Information
Primary practice address
625 Fair Oaks Ave 300
South Pasadena CA 91030-2630
Phone: (626) 395-7100
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ||
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner | 225400000X | ||
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ASW104373 | California |
Profile Details
NPI number | 1740407576 |
---|---|
LBN Legal business name | Tillis, Travon Di Angelo |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 20th, 2007 |
Last updated | Sep 11th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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