MEDICARE: TIFFANY SPEARMAN PMHNP-BC, APRN

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95028075	CA

General Provider Information

NPI Number	:	1497479141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY SPEARMAN PMHNP-BC, APRN

Provider Business Mailing Address
First Line	:	4918 CASTANA AVE APT 14
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90712-7645
Country	:	US
Telephone Number	:	562-275-3553
Fax Number	:	562-213-9942

Provider Business Practice Location Address
First Line	:	17434 BELLFLOWER BLVD STE 200-296
Second Line	:
City	:	BELLFLOWER
State	:	CA
Zip	:	90706-6849
Country	:	US
Telephone Number	:	562-275-3553
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2022
Last Update Date	:	03/14/2025

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