Active NPI
Destiny Tiese Tittle
- Peer Specialist
- Rancho Cucamonga, CA
National Provider Identifier
1154970309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 9570 Center Ave Ste 110
Rancho Cucamonga, CA 91730-5842 - Phone
- (909) 980-2789
- NPI assigned
- Sep 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
9570 Center Ave Ste 110
Rancho Cucamonga, CA 91730-5842
Mailing address
8734 Bellladona Rd
Riverside, CA 92508
Phone (310) 946-3383
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568073600000",
"number": "1154970309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8734 BELLLADONA RD",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "92508",
"telephone_number": "310-946-3383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9570 CENTER AVE STE 110",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917305842",
"telephone_number": "909-980-2789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TITTLE",
"first_name": "DESTINY",
"middle_name": "TIESE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-10",
"last_updated": "2019-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"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 Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.