Individual
TIFFANY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PPS
Contact information
Practice address
11021 SUNNYSIDE DR, YUCAIPA, CA 92399-3336
(909) 790-3270
Mailing address
11021 SUNNYSIDE DR, YUCAIPA, CA 92399-3336
(909) 790-3270
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
CA
Other
Enumeration date
08/08/2025
Last updated
08/08/2025
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