Provider Demographics
NPI:1598455396
Name:FIELDS, TUIANA RENEE
Entity Type:Individual
Prefix:
First Name:TUIANA
Middle Name:RENEE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 N STATE ST # 113
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-6313
Mailing Address - Country:US
Mailing Address - Phone:951-214-5288
Mailing Address - Fax:
Practice Address - Street 1:1281 N STATE ST # 113
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-6313
Practice Address - Country:US
Practice Address - Phone:951-214-5288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst