Healthcare Provider Details

I. General information

NPI: 1497158802
Provider Name (Legal Business Name): TIFFANY JEANNE MORRIS RN, MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2014
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 GRANT ST 319
CONCORD CA
94520-2266
US

IV. Provider business mailing address

4001 J ST
SACRAMENTO CA
95819-3626
US

V. Phone/Fax

Practice location:
  • Phone: 925-674-2880
  • Fax: 925-674-2883
Mailing address:
  • Phone: 916-736-8087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number711562
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95000754
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: