Individual provider Active NPI

Tiffany Mai, CCC-SLP

  • Speech-Language Pathologist
  • Irvine, CA
National Provider Identifier
1043036940
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP37908 Issued in CA
Practice address
17802 Sky Park Cir Ste 104
Irvine, CA 92614-6405
Phone
(949) 771-5881
Fax
(949) 271-4904
NPI assigned
Nov 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP37908 CA Primary

Addresses

Primary practice location

17802 Sky Park Cir Ste 104
Irvine, CA 92614-6405

Mailing address

17802 Sky Park Cir Ste 104
Irvine, CA 92614-6405
Phone (949) 771-5881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250621000258 CA Practitioner - Qualified Speech Language Pathologist 7214449776 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP37908CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Pediatric Therapy LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

1524 Brookhollow Dr
Ste A100
Santa Ana, CA 92705
Phone (949) 771-5881

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1043036940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17802 SKY PARK CIR STE 104",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146405",
            "telephone_number": "949-771-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17802 SKY PARK CIR STE 104",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146405",
            "telephone_number": "949-771-5881",
            "fax_number": "949-271-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "TIFFANY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP37908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.