Provider Demographics
NPI:1306591383
Name:EARNEST, TIFFANY MARIE (MSW)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:EARNEST
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40941
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93384-0941
Mailing Address - Country:US
Mailing Address - Phone:661-340-9349
Mailing Address - Fax:
Practice Address - Street 1:4200 CRESCENT ROCK LN
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-2860
Practice Address - Country:US
Practice Address - Phone:661-491-3402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1273831041C0700X, 1041C0700X
CA88382104100000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator