Individual
TANIA JOSEPHINE DICKSON-HUMPHRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
155 HIGHWAY 50 STE 102, STATELINE, NV 89449-9816
(530) 541-5497
(530) 541-8683
Mailing address
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
(530) 541-3420
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1358
NV
363A00000X
Physician Assistant
PA65355
CA
363AS0400X
Surgical Physician Assistant
PA1358
NV
363AS0400X
Surgical Physician Assistant
PA65355
CA
Other
Enumeration date
07/01/2012
Last updated
11/20/2025
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