Provider Demographics
NPI:1780049213
Name:TOBONI, PATRICIA SWEENY (M,S)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SWEENY
Last Name:TOBONI
Suffix:
Gender:F
Credentials:M,S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 81
Mailing Address - Street 2:
Mailing Address - City:SAN QUENTIN
Mailing Address - State:CA
Mailing Address - Zip Code:94964-0081
Mailing Address - Country:US
Mailing Address - Phone:415-454-4149
Mailing Address - Fax:
Practice Address - Street 1:64 MAIN STREET
Practice Address - Street 2:#2 REAR BLDG.
Practice Address - City:SAN QUENTIN
Practice Address - State:CA
Practice Address - Zip Code:94964
Practice Address - Country:US
Practice Address - Phone:415-454-4149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8616235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist