Individual
ALY TIERNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
940 S COAST DR, COSTA MESA, CA 92626-7735
(949) 743-1457
Mailing address
4007 E KIRKWOOD AVE, ORANGE, CA 92869-5329
(714) 900-9948
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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