Healthcare Provider Details

I. General information

NPI: 1144675810
Provider Name (Legal Business Name): MRS. TIFFANY LAMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2016
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 W VERMONT AVE
ESCONDIDO CA
92025-6584
US

IV. Provider business mailing address

27315 JEFFERSON AVE STE J28
TEMECULA CA
92590-5670
US

V. Phone/Fax

Practice location:
  • Phone: 909-565-8221
  • Fax:
Mailing address:
  • Phone: 909-565-8221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number171M00000X
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: