Provider Demographics
NPI:1346422680
Name:DZIOBA, TIFFANY A
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:A
Last Name:DZIOBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3711 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3315
Mailing Address - Country:US
Mailing Address - Phone:562-216-2172
Mailing Address - Fax:562-216-2337
Practice Address - Street 1:3711 LONG BEACH BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3315
Practice Address - Country:US
Practice Address - Phone:562-216-2172
Practice Address - Fax:562-216-2337
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist