Provider Demographics
NPI:1356849483
Name:ZOLEZZI, TIFFANI ROSE (PT)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANI
Middle Name:ROSE
Last Name:ZOLEZZI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:TIFFANI
Other - Middle Name:ROSE
Other - Last Name:MILAZZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8868 GENTLE WIND DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-4971
Mailing Address - Country:US
Mailing Address - Phone:714-267-3071
Mailing Address - Fax:
Practice Address - Street 1:8868 GENTLE WIND DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-4971
Practice Address - Country:US
Practice Address - Phone:714-267-3071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2020-04-29
Deactivation Date:2018-03-01
Deactivation Code:
Reactivation Date:2020-04-29
Provider Licenses
StateLicense IDTaxonomies
CA22927225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist