| Doctor Name: | TANYA L BYRDSONG |
| NPI Number: | 1033461652 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 397289 |
| Business Practice Address: | 9808 Venice Blvd Suite 700 Culver City, CA - 902322732 |
| Business Phone Number: | 3109453350 |
| Business Fax Number: | 3108407023 |
| Mailing Address: | 9808 Venice Blvd, Suite 700 CULVER CITY |
| State: | CA |
| Postal Code: | 902322732 |
| Phone Number: | 3109453350 |
| Fax Number: | 3108407023 |
| NPI Enumeration Date: | 10/05/2012 |
| NPI Last Update Date: | 10/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 397289 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |