Individual
TIFFANY OLEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27040 CHANNEL LN, VALENCIA, CA 91355-5109
(661) 210-8088
Mailing address
27040 CHANNEL LN, VALENCIA, CA 91355-5109
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
INDIVIDUAL
CA
Enumeration date
06/06/2018
Last updated
06/06/2018
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