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Individual

TYRONE DESAUSSURE SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPT

Contact information

Practice address
212 CARMEN LN STE 201, SANTA MARIA, CA 93458-7771
(805) 212-7680
Mailing address
212 CARMEN LN STE 201, SANTA MARIA, CA 93458-7771
(808) 212-7680

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
36679
CA

Other

Enumeration date
05/11/2026
Last updated
05/11/2026
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