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General NPI Number Information
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NPI Number | 1528275864
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Entity Type | Individual
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Provider Name | TIFFANY JULIETTE AVILA POWELL MD
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Gender | Female
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 2675 HARRIS ST
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City | EUREKA
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State | CA
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Zip | 95503-4806
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Country | US
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Telephone | 707-268-0190
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Fax |
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Provider Business Mailing Address
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Address Line | 14201 DALLAS PKWY
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City | DALLAS
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State | TX
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Zip | 75254-2916
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Country | US
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Telephone | 469-893-2587
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Fax | 469-893-7810
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 0101249185
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | A138522
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MD041720
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License Number State | DC
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