Individual provider Active NPI

Tiffany Gillies, IBCLC

  • Specialist
  • Bakersfield, CA
National Provider Identifier
1194576801
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
L-302719 Issued in CA
Practice address
10415 Atakapa Ave
Bakersfield, CA 93312-5389
Phone
(661) 496-9896
NPI assigned
Mar 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X L-302719 CA Primary

Addresses

Primary practice location

10415 Atakapa Ave
Bakersfield, CA 93312-5389

Mailing address

10415 Atakapa Ave
Bakersfield, CA 93312-5389
Phone (661) 496-9896

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

State licenses

LicenseStateTypeSpecialty
L-302719CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1194576801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10415 ATAKAPA AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933125389",
            "telephone_number": "661-496-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10415 ATAKAPA AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933125389",
            "telephone_number": "661-496-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIES",
        "first_name": "TIFFANY",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "L-302719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.