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NPI Code Detail

MEDICARE: TIFFANY HAMM

MEDICARE: TIFFANY HAMM
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
1101YM0800XMental Health Counselor111472CA
2106S00000XBehavior Technician
3104100000XSocial Worker111472CA

General Provider Information

NPI Number : 1316512247
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY HAMM
Provider Business Mailing Address
First Line : 16552 SUNHILL DR
Second Line :
City : VICTORVILLE
State : CA
Zip : 92395-4518
Country : US
Telephone Number : 760-780-4400
Fax Number :
Provider Business Practice Location Address
First Line : 16552 SUNHILL DR
Second Line :
City : VICTORVILLE
State : CA
Zip : 92395-4518
Country : US
Telephone Number : 760-780-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2021
Last Update Date : 08/10/2023

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Directions to “ TIFFANY HAMM ” Practice Location

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