Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tijuana Temple, FNP

Individual provider Family Nurse Practitioner · NPI 1881369486

Tijuana Temple, FNP is a Nurse Practitioner in Coram, New York. Qualified in 2021, 5 years ago. Practices with Positive Change Psychiatry PLLC, a 6-clinician group and offers telehealth. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2021
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

See every abbreviation used in this directory →

Practice location Address checks out

65 Pennaquid Rd
Coram, NY 11727-1227
Phone: (631) 605-1783
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 348067 (NY)

Record details

NPI number1881369486
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedAugust 16, 2021
Last updated in NPPESAugust 16, 2021
Certification dateJuly 27, 2021
Mailing address65 Pennaquid Rd, Coram, NY 11727-1227

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Positive Change Psychiatry Pllc — 6 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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