Provider Demographics
NPI:1619475381
Name:LAFFEN, TIFFANY L (NP)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:L
Last Name:LAFFEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1360 W 6TH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732
Mailing Address - Country:US
Mailing Address - Phone:310-781-1414
Mailing Address - Fax:310-781-1425
Practice Address - Street 1:18800 MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1717
Practice Address - Country:US
Practice Address - Phone:714-842-8100
Practice Address - Fax:310-325-8109
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2019-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA95008447164W00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No164W00000XNursing Service ProvidersLicensed Practical Nurse