Individual
MARY TIFFANY CERENECHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
333 THALIA ST, LAGUNA BEACH, CA 92651-2713
(949) 499-0577
Mailing address
25 SILKBERRY, IRVINE, CA 92614-7480
(757) 618-3763
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
NP95019956
CA
Other
Enumeration date
06/22/2022
Last updated
05/27/2025
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