Most Relevant Information
Provider Data
| NPI Number: | 1003578485 |
| Provider Name: | TIFFINY ROSA ENRIQUEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/12/2021 |
| Last Updated: | 07/12/2023 |
Provider Practice Location
801 W SAN BERNARDINO RD
COVINA
CA
917223621
Practice Location Phone/Fax
| Phone: | 6265410207 |
| Fax: |
Provider Mailing Location
801 W SAN BERNARDINO RD
COVINA
CA
917223621
Provider Mailing Phone/Fax
| Phone: | 9095921039 |
| Fax: |