Tierney, Mary J

Tierney, Mary J is an individual health care provider with primary practice located at 222 W 39Th Ave , San Mateo CA 94403-4364. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Tierney, Mary J can be contacted via phone (650) 573-2222.

Contact Information

Primary practice address
222 W 39Th Ave San Mateo CA 94403-4364
Phone: (650) 573-2222
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP8020 California

Profile Details

NPI number 1245301571
LBN Legal business name Tierney, Mary J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245301571 NPPES
California MEDICAID RN210322

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