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Individual
TIFFANY RESENDIZ
Active
Individual
TIFFANY RESENDIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
112589
CA
171M00000X
Case Manager/Care Coordinator
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YM0800X
MEDICAL
CA
Enumeration date
10/19/2022
Last updated
12/14/2022
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