Healthcare Provider Details

I. General information

NPI: 1144989658
Provider Name (Legal Business Name): TANIA YEPEZ-STIGER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2021
Last Update Date: 03/30/2022
Certification Date: 12/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 W HOSPITALITY LN
SAN BERNARDINO CA
92408-3243
US

IV. Provider business mailing address

7894 COLD CREEK ST
RIVERSIDE CA
92507-1851
US

V. Phone/Fax

Practice location:
  • Phone: 866-205-3595
  • Fax:
Mailing address:
  • Phone: 619-507-0387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: