Farah Leila Tiab, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

PTL3662 Issued in CA

Practice address

1555 Soquel Dr
Santa Cruz, CA 95065-1705

Phone

(831) 462-7296

NPI assigned

May 24, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: ftiab724609@direct.ochin.org

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1174363410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 SOQUEL DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651705",
            "telephone_number": "831-462-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SOQUEL DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651705",
            "telephone_number": "831-462-7296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIAB",
        "first_name": "FARAH",
        "middle_name": "LEILA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PTL3662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina M Thomsen, MA, AMFT
• Nancy Sharon Thorner, MD
• Valerie Mae Thorp
• Thrifty Payless Inc
• Through Insight
• Tierra Pacifica Charter School
• Lesley Gunsaulus Tierra, L.AC.
• Michael Tierra, O.M.D.
• Tiffany Tuftee Acupuncture Corporation
• Emma Tiffany

• Family Medicine Physician in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.