Doctor Name: | MR. MICHAEL JOHN TYORAN |
NPI Number: | 1003903329 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | LCS 8004 |
Business Practice Address: | 17707 Studebaker Rd Cerritos, CA - 907032640 |
Business Phone Number: | 5624030381 |
Business Fax Number: | |
Mailing Address: | 550 Orange Ave Unit 231, LONG BEACH |
State: | CA |
Postal Code: | 908027001 |
Phone Number: | 5624367160 |
Fax Number: | |
NPI Enumeration Date: | 10/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS 8004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |