Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tiawana Bullock III

Individual provider Counselor · NPI 1306985502

Tiawana Bullock III is a Counselor in San Rafael, California. Registered with an NPI since 2007.

In the registry since
2007

Practice location Address checks out

555 Northgate Dr Family Service Agency Of Marin
San Rafael, CA 94903
Phone: (415) 491-5700
Fax: (415) 491-5750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X

Record details

NPI number1306985502
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 5, 2007
Last updated in NPPESJuly 8, 2007

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