Search › California › 1041C0700X
Keenan Tyner, LCSW
NPI 1023347911 · on the registry since 2009
Practice
- Address
- 2240 Old River Rd
Ukiah, CA 95482 - Phone
- (707) 467-5181
- Organisation at this address
- County Of Mendocino
Mendocino County Superintendent Of SchoolsInferred from a shared address, not stated in the registry. - Clinicians at this address
- 10
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 101Y00000X
101YM0800X
1041C0700X
171M00000X - Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-03-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California