Provider Demographics
NPI:1144660697
Name:YNOQUIO, TIFFANY ROSE LEANO (NP)
Entity type:Individual
Prefix:
First Name:TIFFANY ROSE
Middle Name:LEANO
Last Name:YNOQUIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 MOTT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-4237
Mailing Address - Country:US
Mailing Address - Phone:818-963-5690
Mailing Address - Fax:818-365-0726
Practice Address - Street 1:732 MOTT ST
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4237
Practice Address - Country:US
Practice Address - Phone:818-963-5690
Practice Address - Fax:818-365-0726
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22293363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily