Healthcare Provider Details

I. General information

NPI: 1124809835
Provider Name (Legal Business Name): TIFFANY BAKER-MCFEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27262 VIA INDUSTRIA
TEMECULA CA
92590-3751
US

IV. Provider business mailing address

27262 VIA INDUSTRIA
TEMECULA CA
92590-3751
US

V. Phone/Fax

Practice location:
  • Phone: 951-514-2939
  • Fax:
Mailing address:
  • Phone: 951-514-2939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: