Provider Demographics
NPI:1104567700
Name:TIERREZ, CARA ANN MEGAN (RN)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:ANN MEGAN
Last Name:TIERREZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:
Other - Last Name:ADAMS, DACUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:265 BRISAS CT
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-7972
Mailing Address - Country:US
Mailing Address - Phone:808-756-2076
Mailing Address - Fax:
Practice Address - Street 1:550 W VISTA WAY STE 407
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-5714
Practice Address - Country:US
Practice Address - Phone:760-758-8481
Practice Address - Fax:760-758-8481
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95170101163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse