Healthcare Provider Details

I. General information

NPI: 1093652661
Provider Name (Legal Business Name): TIFFANY ANDREINA OSEJO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ESPEN ANDREINA OSEJO

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8391 AUBURN BLVD
CITRUS HEIGHTS CA
95610-0364
US

IV. Provider business mailing address

8391 AUBURN BLVD
CITRUS HEIGHTS CA
95610-0364
US

V. Phone/Fax

Practice location:
  • Phone: 916-923-5444
  • Fax:
Mailing address:
  • Phone: 916-923-5444
  • Fax: 916-931-5022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: