MS. TIFFANY RENEE' ELLIS (NPI# 1699964585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699964585 |
| Entity Type | Individual |
| Full Name | MS. TIFFANY RENEE' ELLIS |
| Practice Address |
1120 3rd St South Lake Tahoe CA 96150-3451 |
| Practice Telephone | 5305733386 |
| Practice Fax Number | 5305436697 |
| Mailing Telephone | 5305733386 |
| Mailing Fax Number | 5305436697 |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2007-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789892 | Tiffany Marie Ellis | Technician | 682 Gilbert Creek Rd, Baisden, WV 25608-0803 | 2020-10-28 |
| 1982001087 | Tiffany Ellis | Technician | 140 Sandalwood Dr, Felton, DE 19943-2937 | 2014-12-04 |
| 1982249587 | Tiffany Ellis | Nurse Practitioner | 22032 El Paseo Ste 130, Rancho Santa Margarita, CA 92688-3947 | 2019-11-07 |
| 1417216193 | Tiffany Marie Ellis | Nurse Practitioner | 508 Fulton St, Durham, NC 27705-3875 | 2012-05-15 |
| Street Address |
1120 3RD ST |
| City | SOUTH LAKE TAHOE |
| State | CA |
| Zip Code | 96150-3451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174645840 | Michelle Francik | Day Training, Developmentally Disabled Services | 1120 3rd St, South Lake Tahoe, CA 96150-3451 | 2007-04-04 |
| 1215152582 | Linda Hardin Bingham | Social Worker | 1120 3rd St, South Lake Tahoe, CA 96150-3451 | 2007-04-13 |
| 1780808204 | Arlene B Hayward | Social Worker | 1120 3rd St, South Lake Tahoe, CA 96150-3451 | 2007-04-13 |
| 1760606446 | Keith Anthony Taylor | Counselor | 1120 3rd St, South Lake Tahoe, CA 96150-3451 | 2007-04-12 |
| 1003039512 | Amy Lynne Lovell | Counselor | 1120 3rd St, South Lake Tahoe, CA 96150-3451 | 2007-04-11 |
| 1881817757 | James Borgman | Counselor | 1120 3rd St, South Lake Tahoe, CA 96150-3451 | 2007-04-10 |
| 1184747529 | Mercedes Ruiz | Counselor | 1120 3rd St, South Lake Tahoe, CA 96150-3451 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750818969 | Terri Wong | Behavior Technician | 908 Alameda Ave, #b, South Lake Tahoe, CA 96150 | 2017-05-18 |
| 1154735157 | Catherine Anne Jones | Dental Hygienist | 1088 4th St # 6, South Lake Tahoe, CA 96150 | 2014-06-17 |
| 1245663194 | Sheila Marie Gwin | Behavioral Analyst | 2111south Ave, South Lake Tahoe, CA 96150 | 2013-08-14 |
| 1164785598 | Launa Jean Martin | Doula | 1399 Bozeman Dr, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1881957355 | Elizabeth Marilyn Mcnamara | Emergency Medicine | Barton Memorial Hospital, 2107 South Ave, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1295034627 | Dana Elizabeth Cox | Chiropractor | 3097 Harrison Ave., # 202, S. Lake Tahoe, CA 96150 | 2011-03-24 |
| 1639485162 | April Lyn Westfall | Dentist | 3358 Sandy Way, # B, S Lake Tahoe, CA 96150 | 2010-08-21 |
| 1700199270 | Rollie E Rohnow | Pharmacist | 1020 Al Tahoe Blvd, Rite Aid Pharmacy, South Lake Tahoe, CA 96150 | 2010-07-26 |
| 1699000455 | Ellen Newell Mccullough | Physical Therapist | 1900 High Meadow Trail, South Lake Tahoe, CA 96150 | 2009-10-13 |
| 1093941148 | Ashley Elizabeth Bedell | Counselor | 1137 Emerald Bay Rd., South Lake Tahoe, CA 96150 | 2009-06-03 |
| Find all providers in zip 96150 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235654567 | Justin Marshall | Counselor | 1041 Al Tahoe Blvd, South Lake Tahoe, CA 96150-4502 | 2017-08-08 |
| 1063753648 | Misty Dawn Dee | Counselor | 2494 Lake Tahoe Blvd Suite B-5, South Lake Tahoe, CA 96151-7509 | 2013-03-07 |
| 1760768964 | Karen Naegeli | Counselor | 2494 Lake Tahoe Blvd Ste B5, South Lake Tahoe, CA 96150-7142 | 2011-11-01 |
| 1508153834 | Pamela Armstrong | Counselor | 3540 April Dr, South Lake Tahoe, CA 96150-7313 | 2011-07-07 |
| 1093941148 | Ashley Elizabeth Bedell | Counselor | 1137 Emerald Bay Rd., South Lake Tahoe, CA 96150 | 2009-06-03 |
| 1275737421 | Kurt Sturgeon | Counselor | 921 Macinaw Rd, Suite 2, South Lake Tahoe, CA 96150-3525 | 2007-06-12 |
| 1730301128 | Walter Pedersen | Counselor | 2494 Lake Tahoe Blvd Ste B2, South Lake Tahoe, CA 96150-7142 | 2007-05-03 |
| 1932719028 | Dustin John Wedekind | Counselor | 1021 Fremont Ave, South Lake Tahoe, CA 96150-8136 | 2020-08-04 |
| 1346621273 | Justin Eastman | Counselor | 2494 Lake Tahoe Blvd, Suite B6, South Lake Tahoe, CA 96150-7719 | 2015-06-16 |
| 1194066738 | Susie Stich | Counselor | 2494 Lake Tahoe Blvd, B-5, South Lake Tahoe, CA 96150-7719 | 2013-03-06 |
| Find all providers in SOUTH LAKE TAHOE | ||||
| City | SOUTH LAKE TAHOE |
| Zip Code | 96150 |
Please comment or provide details below to improve the information on MS. TIFFANY RENEE' ELLIS.
| 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.