Healthcare Provider Details

I. General information

NPI: 1073778767
Provider Name (Legal Business Name): TINA MICHELLE HUFF NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TINA MICHELLE TAYLOR RN

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58383 29 PALMS HWY STE 101
YUCCA VALLEY CA
92284-5891
US

IV. Provider business mailing address

58880 SAN MARINO DR
YUCCA VALLEY CA
92284-6415
US

V. Phone/Fax

Practice location:
  • Phone: 760-820-9229
  • Fax:
Mailing address:
  • Phone: 858-232-0297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95011228
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95011228
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: