Individual
JONATHAN TENNISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.S., NCSP, LEP
Contact information
Practice address
4192 PIEDMONT AVE, OAKLAND, CA 94611-5133
(512) 565-0187
Mailing address
PO BOX 20703, OAKLAND, CA 94620-0703
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4358
CA
Other
Enumeration date
11/27/2023
Last updated
11/27/2023
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