MEDICARE: TIANA MASTRELLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251K00000X	Public Health or Welfare Agency
2	374J00000X	Doula
3	174H00000X	Health Educator

General Provider Information

NPI Number	:	1144086646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIANA MASTRELLA

Provider Business Mailing Address
First Line	:	2077 HILLSBURY RD
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-3529
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1635 E ANAHEIM ST STE A
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-7120
Country	:	US
Telephone Number	:	805-242-2131
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2024
Last Update Date	:	03/20/2024

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Directions to “ TIANA MASTRELLA ” Practice Location

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