Individual
TIFFANY SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1551 E TANGERINE RD, ORO VALLEY, AZ 85755-6213
(520) 901-3500
Mailing address
3600 BROADWAY, OAKLAND, CA 94611-5730
(510) 752-1100
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
95066323
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
323640
AZ
367500000X
Certified Registered Nurse Anesthetist
95001686
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95066323
BOARD OF NURSING
CA
Enumeration date
08/08/2019
Last updated
06/12/2025
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