Individual
TIFFANY WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2405 SHADELANDS DR, WALNUT CREEK, CA 94598-2444
(925) 939-8585
(925) 933-2709
Mailing address
PO BOX 31396, WALNUT CREEK, CA 94598-8396
(925) 939-8585
(925) 933-2709
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA17246
CA
363AS0400X
Surgical Physician Assistant
Primary
PA17246
CA
Other
Enumeration date
06/30/2006
Last updated
11/07/2013
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