Provider Demographics
NPI:1235445917
Name:VALENCIANA, TIFFANY JENELLE (MA)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:JENELLE
Last Name:VALENCIANA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 GRANITE PRIVADO
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-6865
Mailing Address - Country:US
Mailing Address - Phone:909-239-7192
Mailing Address - Fax:
Practice Address - Street 1:540 S EREMLAND DR STE E
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3186
Practice Address - Country:US
Practice Address - Phone:626-966-1577
Practice Address - Fax:626-331-4529
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program