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TIAWANA BULLOCK III
NPI 1306985502
Counselor in San Rafael, CA

Active since February 05, 2007
555 NORTHGATE DR, FAMILY SERVICE AGENCY OF MARIN, SAN RAFAEL, CA 94903(415) 491-5700(415) 491-5750 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tiawana Bullock Iii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIAWANA BULLOCK III (NPI 1306985502) is an individual counselor in San Rafael, California and active in the NPI registry since February 2007.

NPPES Registry Identity

NPI1306985502
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameTIAWANA BULLOCK III
Location Address555 NORTHGATE DR, FAMILY SERVICE AGENCY OF MARINSan Rafael, CA 94903
Mailing Address555 Northgate Dr, Family Service Agency Of MarinSan Rafael, CA 94903 · (415) 491-5700 · Fax (415) 491-5750
Phone(415) 491-5700
Fax(415) 491-5750
Sole ProprietorNo
Enumeration DateFebruary 5, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1306985502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
555 NORTHGATE DR, San Rafael, CA 94903
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LISA WYNLAND LUKIANOFF
Counselor (Mental Health)
555 NORTHGATE DR, FAMILY SERVICE AGENCY OF MARIN
SAN RAFAEL, CA 94903
Marin County (415) 491-5700
FAMILY SERVICE AGENCY
Community/Behavioral Health
555 NORTHGATE DR, FAMILY SERVICE AGENCY OF MARIN
SAN RAFAEL, CA 94903
Marin County (415) 491-5700
MRS. MELISSA LEE
Counselor (Mental Health)
555 NORTHGATE DR, FAMILY SERVICE AGENCY OF MARIN
SAN RAFAEL, CA 94903
Marin County (415) 491-5700
MEGAN MCKEON
Counselor
555 NORTHGATE DR
SAN RAFAEL, CA 94903
Marin County (510) 332-9828
AMY N HARRIS
Counselor (Mental Health)
555 NORTHGATE DR, FAMILY SERVICE AGENCY OF MARIN
SAN RAFAEL, CA 94903
Marin County (415) 491-5700
MS. CARIN EBEY M.S.
Counselor (Mental Health)
555 NORTHGATE DR, FAMILY SERVICE AGENCY
SAN RAFAEL, CA 94903
Marin County (415) 491-5700
ESME IRENE GORDON MFT
Marriage & Family Therapist
555 NORTHGATE DR, FAMILY SERVICE AGENCY OF MARIN
SAN RAFAEL, CA 94903
Marin County (415) 491-5700
CORDELIA WOLF
Counselor (Mental Health)
555 NORTHGATE DR
SAN RAFAEL, CA 94903
Marin County (310) 621-4696

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiawana Bullock's NPI number?

The NPI number for Tiawana Bullock is 1306985502. It was assigned to this individual provider in the NPPES registry on February 5, 2007.

Where is Tiawana Bullock located?

Tiawana Bullock practices at 555 Northgate Dr Family Service Agency Of Marin, San Rafael, CA 94903. The listed phone number is (415) 491-5700.

What is Tiawana Bullock's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Tiawana Bullock was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.