Provider Demographics
NPI:1164239745
Name:TOBLER, WENDE A
Entity type:Individual
Prefix:
First Name:WENDE
Middle Name:A
Last Name:TOBLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:WENDE
Other - Middle Name:A
Other - Last Name:TOBLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WARD
Mailing Address - Street 1:1200 CONCORD AVE STE 185
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5006
Mailing Address - Country:US
Mailing Address - Phone:510-268-8120
Mailing Address - Fax:
Practice Address - Street 1:1200 CONCORD AVE STE 185
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5006
Practice Address - Country:US
Practice Address - Phone:510-268-8120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician