Provider Demographics
NPI:1497479141
Name:SPEARMAN, TIFFANY (RN)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:SPEARMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4918 CASTANA AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-7645
Mailing Address - Country:US
Mailing Address - Phone:562-275-3553
Mailing Address - Fax:562-213-9942
Practice Address - Street 1:17434 BELLFLOWER BLVD STE 200-296
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6849
Practice Address - Country:US
Practice Address - Phone:562-275-3553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95203382163W00000X
CA95028075363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse