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General NPI Number Information
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NPI Number | 1780323519
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Entity Type | Individual
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Provider Name | TIFFANY SUE CARSON BACHELOR OF SCIENCE
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Gender | Female
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 1151 DOVE ST
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2840
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Country | US
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Telephone | 855-443-3822
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Fax |
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Provider Business Mailing Address
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Address Line | 8265 WHITE OAK AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730
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Country | US
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Telephone | 909-362-2932
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Fax |
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | NA
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License Number State | CA
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