Provider Demographics
NPI:1144771932
Name:SAUCER, TIFFANY R (DSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:R
Last Name:SAUCER
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CORPORATE POINTE STE 270
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-8735
Mailing Address - Country:US
Mailing Address - Phone:424-266-7472
Mailing Address - Fax:
Practice Address - Street 1:5901 GREEN VALLEY CIR STE 405
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6971
Practice Address - Country:US
Practice Address - Phone:424-266-7474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical