Individual
MS. TANYA MARIE CARIVEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2020 SANTA MONICA BLVD DEPT STE 400, SANTA MONICA, CA 90404-2023
(310) 829-2663
Mailing address
11662 IOWA AVE, LOS ANGELES, CA 90025-4039
(310) 962-3343
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
PA17796
CA
363AS0400X
Surgical Physician Assistant
Primary
PA17796
CA
Other
Enumeration date
02/14/2007
Last updated
04/29/2022
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