Tiffany Danielle Sutphen

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1156 N 4TH St
San Jose, CA 95112-4900

Phone

(408) 775-8768

NPI assigned

Aug 31, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Abode Services

  • Case Management Agency
  • San Jose, CA
  • NPI 1902292501
  NPD (past)

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235657057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 N 4TH ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95112",
            "telephone_number": "408-775-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 N 4TH ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951124900",
            "telephone_number": "408-775-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTPHEN",
        "first_name": "TIFFANY",
        "middle_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Sina Sussman, MD
• Lanny Sutanto
• Jennifer Jean Sutera, BCBA
• Silvia Haydee Suther, PPS
• Rachel Elizabeth Sutherland, MD
• Sutter Bay Medical Foundation
• Sutter Bay Medical Foundation
• Sutter Bay Medical Foundation
• Sutter Bay Medical Foundation
• Sutter Bay Medical Foundation

• Community Health Worker in San Jose, CA
• Providers in San Jose, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.