TIFFANY KELLY (NPI# 1639615032) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639615032 |
| Entity Type | Individual |
| Full Name | TIFFANY KELLY |
| Practice Address |
555 N Perris Blvd Perris CA 92571 |
| Mailing Address |
555 N Perris Blvd Perris CA 92571-2811 |
| Practice Telephone | 9514365366 |
| Mailing Telephone | 9514365366 |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2019-10-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 555 N Perris Blvd, Perris, CA 92571 | 9514365366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508413659 | Tiffany Kelly | Behavioral Analyst | 100 Dakota Dr, White House, TN 37188-4333 | 2019-08-23 |
| 1174070346 | Tiffany Kelly | Speech-Language Pathologist | 6809 Galway Dr, Garland, TX 75044-3409 | 2016-09-06 |
| 1346574035 | Tiffany Marie Kelly | Counselor | 210 W Sprague Ave, Spokane, WA 99201-3627 | 2009-09-28 |
| 1902060494 | Tiffany Sue Kelly | Speech-Language Pathologist | 200 W Green Meadows Dr, Greenfield, IN 46140-1014 | 2008-07-14 |
| Street Address |
555 N PERRIS BLVD |
| City | PERRIS |
| State | CA |
| Zip Code | 92571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447340526 | Danielle Marie Gross | Marriage & Family Therapist | 555 N Perris Blvd, Building A, Perris, CA 92571-2811 | 2006-10-13 |
| 1093332751 | Frida Jacinto | Counselor | 555 N Perris Blvd, Perris, CA 92571-2811 | 2020-06-29 |
| 1881233971 | Monica Mora | Social Worker | 555 N Perris Blvd, Perris, CA 92571-2811 | 2020-01-06 |
| 1316592827 | Kelli Brower | Counselor | 555 N Perris Blvd, Perris, CA 92571-2811 | 2019-08-02 |
| 1376195537 | Ilse Perez | Counselor | 555 N Perris Blvd, Perris, CA 92571-2811 | 2019-07-09 |
| 1558926303 | Alanna Gonzalez | Counselor | 555 N Perris Blvd, Perris, CA 92571-2811 | 2019-05-07 |
| 1386109965 | Cristal Cortes Vazquez | Counselor | 555 N Perris Blvd, Perris, CA 92571-2811 | 2019-02-07 |
| 1124595780 | Suzanna Anderson | Counselor | 555 N Perris Blvd, Perris, CA 92571-2811 | 2018-10-31 |
| 1508333154 | Michele Foreman-boggus | Social Worker | 555 N Perris Blvd, Perris, CA 92571-2811 | 2018-10-31 |
| 1790267623 | Rachelle Felix | Counselor | 555 N Perris Blvd, Perris, CA 92571-2811 | 2018-09-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376199422 | Pico De Loro, Incorporated | Assisted Living Facility | 620 North Perris Boulevard, Perris, CA 92571 | 2019-08-14 |
| 1053802579 | Kadiatou Dafney | Nurse Practitioner | 126 Avocado Ave Ste 106, Perris, CA 92571 | 2018-05-21 |
| 1730677014 | Ruth Gasselle Rodriguez | Nutritionist | 1020 Huntington Way, Perris, CA 92571 | 2018-04-23 |
| 1649788167 | Leslie Bautista | Counselor | 1276 Autumnwood Ln, Perris, CA 92571 | 2018-01-18 |
| 1588180459 | Eduardo Orozco-zavala | Licensed Vocational Nurse | 85 Ramona Expressway, Suite 1, Perris, CA 92571 | 2017-08-22 |
| 1396267365 | National Vision, Inc. | Technician/Technologist | 1850 N Perris Boulevard, Suite 40, Perris, CA 92571 | 2017-07-12 |
| 1336669506 | Gary Huang | Optometrist | 1850 N Perris Boulevard Ste 40, Perris, CA 92571 | 2017-06-20 |
| 1750814745 | New Beginnings Residential Tf | Residential Treatment Facility, Emotionally Disturbed Children | 106 Worth St, Perris, CA 92571 | 2017-04-06 |
| 1013456235 | Sohal and Pham Dental Corporation | Dentist | 1820 Perris Blvd, Suite 70, Perris, CA 92571 | 2017-02-21 |
| 1093267569 | New Beginnings Residential Tf | Residential Treatment Facility, Emotionally Disturbed Children | 2464 Slew of Gold Ct, Perris, CA 92571 | 2016-10-31 |
| Find all providers in zip 92571 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720696503 | Bernadette Mendoza | Case Manager/Care Coordinator | 170 Wilkerson Ave Ste Candd, Perris, CA 92570-2200 | 2020-07-17 |
| 1801330188 | Maria Huerta | Case Manager/Care Coordinator | 1688 N Perris Blvd Ste L6-l11, Perris, CA 92571-4709 | 2016-12-06 |
| 1720438500 | Ledilla Campbell | Case Manager/Care Coordinator | 3807 Carnelian Ct, Perris, CA 92570-7291 | 2016-06-13 |
| 1255785861 | Teresa Leon | Case Manager/Care Coordinator | 1688 N Perris Bldv, Suite L6-11, Perris, CA 92571 | 2016-04-20 |
| 1295126548 | Rosie Pope | Case Manager/Care Coordinator | 1688 N Perris Blvd # L711, Perris, CA 92571-4709 | 2015-02-09 |
| 1134546617 | Fernando Luis Moulton | Case Manager/Care Coordinator | 1688 Perris Blvd, Suite L6-11, Perris, CA 92571 | 2014-03-24 |
| 1992130223 | Beverly Christian | Case Manager/Care Coordinator | 1688 N Perris Blvd Ste L1, Perris, CA 92571-4701 | 2013-09-05 |
| 1336498112 | Areli Ramirez Gonzalez | Case Manager/Care Coordinator | 528 Fair Park Way, Perris, CA 92570-3470 | 2012-09-07 |
| 1710009790 | Enedina Avena | Case Manager/Care Coordinator | 1688 N Perris Blvd Ste L7-11, Perris, CA 92571-4709 | 2007-04-03 |
| 1265504492 | Bertha Catalina Merino | Case Manager/Care Coordinator | 1688 N Perris Blvd Ste L7-l11, Perris, CA 92571-4709 | 2006-11-14 |
| Find all providers in PERRIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.