Individual provider · Type 1 NPI

Tiffany Ann Cervenak, NP

Nurse Practitioner · Laguna Hills, CA

NPI number 1104803543 Active

Practice location

24012 Calle De La Plata, Suite 150
Laguna Hills, CA 92653-3621

Fax (949) 837-8154

Mailing address

3080 Bristol St, Suite 600
Costa Mesa, CA 92626-3093

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X10177 (CA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1104803543

Tiffany Ann Cervenak, NP's National Provider Identifier is 1104803543, issued on Dec 28, 2005. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Laguna Hills, CA. The record was last updated on Jul 13, 2026.