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General NPI Number Information
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NPI Number | 1548506579
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Entity Type | Individual
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Provider Name | KARA TIFFANY-ROBERTS M.A., LMFT, LAADC
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Gender | Female
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Dates
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Enumeration Date | 12/19/2012
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 25114 JEFFERSON AVE STE A
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City | MURRIETA
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State | CA
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Zip | 92562-1701
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Country | US
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Telephone | 951-795-5828
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1273
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City | MURRIETA
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State | CA
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Zip | 92564-1273
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Country | US
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Telephone | 951-201-9363
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Fax | 951-767-8413
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LR 1581012
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 52503
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License Number State | CA
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