Provider Demographics
NPI:1033739677
Name:TURNER, TIFFANY VENICE (RN)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:VENICE
Last Name:TURNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4156 ISABELLA CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-2033
Mailing Address - Country:US
Mailing Address - Phone:310-704-4602
Mailing Address - Fax:
Practice Address - Street 1:2085 RUSTIN AVE BLDG 5
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-2498
Practice Address - Country:US
Practice Address - Phone:951-509-2400
Practice Address - Fax:951-509-2404
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA808242163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult