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Individual

AZELEAH CARLA TIAMSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
160 E VIRGINIA ST STE 100, SAN JOSE, CA 95112-5865
(408) 938-2113
(408) 579-6143
Mailing address
160 E VIRGINIA ST STE 100, SAN JOSE, CA 95112-5865
(408) 938-2113
(408) 579-6143

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
225400000X
Rehabilitation Practitioner
Primary
CA

Other

Enumeration date
02/10/2020
Last updated
07/08/2026
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