Provider Demographics
NPI:1841882867
Name:TIJERA, KENIA
Entity type:Individual
Prefix:
First Name:KENIA
Middle Name:
Last Name:TIJERA
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 1:900 CORPORATE CENTER DIVE SUITE 350
Mailing Address - Street 2:
Mailing Address - City:MONTERREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754
Mailing Address - Country:US
Mailing Address - Phone:323-526-4016
Mailing Address - Fax:323-526-4096
Practice Address - Street 1:900 CORPORATE CENTER DIVE SUITE 350
Practice Address - Street 2:
Practice Address - City:MONTERREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754
Practice Address - Country:US
Practice Address - Phone:323-526-4016
Practice Address - Fax:323-526-4096
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program