Provider Demographics
NPI:1447684196
Name:ABRAJANO, TIFFANIE (RN)
Entity type:Individual
Prefix:MISS
First Name:TIFFANIE
Middle Name:
Last Name:ABRAJANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8838 RAGWEED CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4146
Mailing Address - Country:US
Mailing Address - Phone:858-248-3944
Mailing Address - Fax:
Practice Address - Street 1:8838 RAGWEED CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-4146
Practice Address - Country:US
Practice Address - Phone:858-248-3944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA764482163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse