Individual provider Active NPI

Tiffany Verduzco

  • Behavior Technician
  • Rancho Cucamonga, CA
National Provider Identifier
1053902379
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
9600 Center Ave Ste 160
Rancho Cucamonga, CA 91730-5838
Phone
(858) 264-5858
Fax
(858) 649-6012
NPI assigned
Jan 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary
Health & Wellness Coach 171400000X CA

Addresses

Primary practice location

9600 Center Ave Ste 160
Rancho Cucamonga, CA 91730-5838

Mailing address

19160 Hudson Rd
Apple Valley, CA 92307-5911

Other practice location 1

12555 Navajo Rd
Apple Valley, CA 92308-7256
Phone (760) 247-8001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Valley Unified School District PastSince Jun 3, 2025 Accepting new patients

Organizations & group practices 1

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": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1053902379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19160 HUDSON RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923075911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 CENTER AVE STE 160",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305838",
            "telephone_number": "858-264-5858",
            "fax_number": "858-649-6012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12555 Navajo Rd",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923087256",
            "country_code": "US",
            "telephone_number": "760-247-8001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERDUZCO",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.