MEDICARE: TIFFANY GISHIZKY DNP, RN, PMHNP-BC

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	95012240	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	95012240	OTHER	CA	BOARD OF REGISTERED NURSING

General Provider Information

NPI Number	:	1760035935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY GISHIZKY DNP, RN, PMHNP-BC

Provider Business Mailing Address
First Line	:	1001 2ND ST STE 225
Second Line	:
City	:	NAPA
State	:	CA
Zip	:	94559-3030
Country	:	US
Telephone Number	:	707-346-6825
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 2ND ST STE 225
Second Line	:
City	:	NAPA
State	:	CA
Zip	:	94559-3030
Country	:	US
Telephone Number	:	707-346-6825
Fax Number	:

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

Provider Enumeration Date	:	07/17/2019
Last Update Date	:	01/12/2026

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