Individual
TENNILLE GREENFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2720 N HARBOR BLVD STE 210, FULLERTON, CA 92835-2626
(714) 446-5192
(714) 515-8360
Mailing address
2720 N HARBOR BLVD STE 210, FULLERTON, CA 92835-2626
(714) 446-5192
(714) 515-8360
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA17945
CA
363AS0400X
Surgical Physician Assistant
Primary
PA17945
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA17945
LICENSE
CA
Enumeration date
05/18/2007
Last updated
11/02/2021
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