Provider Demographics
NPI:1457682155
Name:BARNES, TIFFANY (RN, MSN, PHN)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:RN, MSN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 PIERCE ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-4640
Mailing Address - Country:US
Mailing Address - Phone:925-313-6986
Mailing Address - Fax:925-313-6188
Practice Address - Street 1:1301 PIERCE ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-4005
Practice Address - Country:US
Practice Address - Phone:925-313-6986
Practice Address - Fax:925-313-6188
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA675485163WC0400X
CA2717364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist