Individual provider Active NPI

Tiffany Estera, FNP-C

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1053880567
Registry record updated May 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010281 Issued in CA
Practice address
5717 Pacific Center Blvd Ste 200
San Diego, CA 92121-4250
Phone
(858) 859-1188
NPI assigned
Nov 14, 2018
Last updated
May 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95010281 CA Primary

Addresses

Primary practice location

5717 Pacific Center Blvd Ste 200
San Diego, CA 92121-4250

Mailing address

5717 Pacific Center Blvd Ste 200
San Diego, CA 92121-4250
Phone (858) 859-1188

Other practice location 1

661 W 1st St Ste G
Tustin, CA 92780-2939
Phone (714) 665-9890

Other practice location 2

9918 Katella Ave
Anaheim, CA 92804-6465
Phone (714) 644-9494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110000171 AZ Order and Referring Only - Nurse Practitioner 2860843299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95010281CAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: tiffany.estera.1@19960.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619913600000",
    "number": "1053880567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 PACIFIC CENTER BLVD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214250",
            "telephone_number": "858-859-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5717 PACIFIC CENTER BLVD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214250",
            "telephone_number": "858-859-1188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "661 W 1st St Ste G",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927802939",
            "country_code": "US",
            "telephone_number": "714-665-9890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9918 Katella Ave",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928046465",
            "country_code": "US",
            "telephone_number": "714-644-9494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTERA",
        "first_name": "TIFFANY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.