Individual
TYNESHA WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
(714) 203-2181
Mailing address
13064 THICKET PL, CORONA, CA 92883-6347
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
95038465
CA
Other
Enumeration date
04/29/2026
Last updated
04/29/2026
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