Provider Demographics
NPI:1326833450
Name:PRIESTLEY, TATIANA
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:PRIESTLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 STENNETT ST
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-6825
Mailing Address - Country:US
Mailing Address - Phone:209-559-3006
Mailing Address - Fax:
Practice Address - Street 1:127 STENNETT ST
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-6825
Practice Address - Country:US
Practice Address - Phone:209-559-3006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula