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NPI Code Detail

MEDICARE: TIFFANY HERD

MEDICARE: TIFFANY HERD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist111351CA
2106H00000XMarriage & Family TherapistLMFT111351CA

General Provider Information

NPI Number : 1013357862
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY HERD
Provider Business Mailing Address
First Line : 4160 TEMESCAL CANYON RD STE 401
Second Line :
City : CORONA
State : CA
Zip : 92883-4626
Country : US
Telephone Number : 951-444-1773
Fax Number :
Provider Business Practice Location Address
First Line : 4160 TEMESCAL CANYON RD STE 401
Second Line :
City : CORONA
State : CA
Zip : 92883-4626
Country : US
Telephone Number : 951-444-1773
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2013
Last Update Date : 09/12/2022

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Directions to “ TIFFANY HERD ” Practice Location

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