Healthcare Provider Details

I. General information

NPI: 1215895818
Provider Name (Legal Business Name): TAMMY ADLER RN, BSN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3576 ARLINGTON AVE STE 106
RIVERSIDE CA
92506-3907
US

IV. Provider business mailing address

22920 SIERRA TRL
CANYON LAKE CA
92587-7804
US

V. Phone/Fax

Practice location:
  • Phone: 951-788-5905
  • Fax:
Mailing address:
  • Phone: 951-788-5905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN428866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: