Provider Demographics
NPI:1568191807
Name:AARONSEN, TIFFANNE MARITZA (FNP)
Entity Type:Individual
Prefix:MS
First Name:TIFFANNE
Middle Name:MARITZA
Last Name:AARONSEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29825 HAPPY VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92241-5162
Mailing Address - Country:US
Mailing Address - Phone:760-393-1427
Mailing Address - Fax:
Practice Address - Street 1:81767 DOCTOR CARREON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5598
Practice Address - Country:US
Practice Address - Phone:760-347-1615
Practice Address - Fax:760-347-1635
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95146932163W00000X
CA95017872363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
012850537OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS
95017872OtherCALIFORNIA BOARD OF NURSING- NURSE PRACTIONER
CA95017872OtherCALIFORNIA BOARD OF NURSING FURNISHING
95146932OtherCALIFORNIA BOARD OF NURSING RN LICENSE