Active NPI
Tiffany Phalavisay, RRT
- Registered Respiratory Therapist
- Riverside, CA
National Provider Identifier
1215533948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Respiratory Therapist
- License
- 40995
- Practice address
- 9377 Dauchy Ave
Riverside, CA 92508-9346 - Phone
- (909) 561-2154
- NPI assigned
- Dec 8, 2020
- 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 |
|---|---|---|---|---|
| Registered Respiratory Therapist | 227900000X | 40995 | CA | Primary |
Addresses
Primary practice location
9377 Dauchy Ave
Riverside, CA 92508-9346
Mailing address
9377 Dauchy Ave
Riverside, CA 92508-9346
Phone (909) 561-2154
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20170500094900 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40995 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607385600000",
"number": "1215533948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9377 DAUCHY AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925089346",
"telephone_number": "909-561-2154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9377 DAUCHY AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925089346",
"telephone_number": "909-561-2154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHALAVISAY",
"first_name": "TIFFANY",
"credential": "RRT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-08",
"last_updated": "2020-12-08",
"certification_date": "2020-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "227900000X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Registered",
"state": "CA",
"license": "40995",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20170500094900",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.