Provider Demographics
NPI:1558912949
Name:WILLOUGHBY, TEMPEST LAPIA
Entity type:Individual
Prefix:MS
First Name:TEMPEST
Middle Name:LAPIA
Last Name:WILLOUGHBY
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 1:1430 E COOLEY DR STE 111
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-3944
Mailing Address - Country:US
Mailing Address - Phone:909-420-0413
Mailing Address - Fax:909-514-0410
Practice Address - Street 1:1430 E COOLEY DR STE 111
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3944
Practice Address - Country:US
Practice Address - Phone:909-420-0413
Practice Address - Fax:909-514-0410
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator