Individual provider · Type 1 NPI

Tierra Tenay Derusha

Student in an Organized Health Care Education/Training Program · Sacramento, CA

NPI number 1700645165 Active

Practice location

4860 Y St Ste 1600
Sacramento, CA 95817-2307

Call (916) 734-3630 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1700645165

Tierra Tenay Derusha's National Provider Identifier is 1700645165, issued on Mar 18, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Sacramento, CA. The record was last updated on Apr 5, 2024.