Provider Demographics
NPI:1467331272
Name:LOMELI, TONY DAVID JR (ANTONIO)
Entity type:Individual
Prefix:
First Name:TONY
Middle Name:DAVID
Last Name:LOMELI
Suffix:JR
Gender:M
Credentials:ANTONIO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1581 CUMMINS DR STE B
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95358-6402
Mailing Address - Country:US
Mailing Address - Phone:209-574-1600
Mailing Address - Fax:
Practice Address - Street 1:1581 CUMMINS DR STE B
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95358-6402
Practice Address - Country:US
Practice Address - Phone:209-574-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool