Provider Demographics
NPI:1124355565
Name:PREUSCHOFF, TIFFANY (PT, DPT, NCS)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:PREUSCHOFF
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3294 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2426
Mailing Address - Country:US
Mailing Address - Phone:562-988-3570
Mailing Address - Fax:562-988-3671
Practice Address - Street 1:3294 E SPRING ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2426
Practice Address - Country:US
Practice Address - Phone:562-988-3570
Practice Address - Fax:562-988-3671
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35834225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist