Provider Demographics
NPI:1477969715
Name:JAMES, TIFFANY (LVN)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 FINNEY RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95358-9765
Mailing Address - Country:US
Mailing Address - Phone:209-550-5858
Mailing Address - Fax:
Practice Address - Street 1:2524 FINNEY RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95358-9765
Practice Address - Country:US
Practice Address - Phone:209-550-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA257558164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse