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General NPI Number Information
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NPI Number | 1922390533
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Entity Type | Individual
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Provider Name | TIFFANI GRANT M.S., PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/15/2011
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Last Update Date | 11/18/2019
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Provider Practice Location Address
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Address Line | 310 N IRWIN ST STE 14
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City | HANFORD
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State | CA
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Zip | 93230-4479
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Country | US
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Telephone | 559-309-4151
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Fax |
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Provider Business Mailing Address
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Address Line | 187 E. POLK STREET, #62
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City | COALINGA
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State | CA
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Zip | 93210
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Country | US
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Telephone | 951-746-9383
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY30566
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License Number State | CA
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