Tiffany Nickerson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA68366 Issued in CA

Practice address

7512 Morro Rd
Atascadero, CA 93422-4404

Phone

(805) 792-1400

Fax

(805) 792-1485

NPI assigned

Aug 4, 2016

Last updated

Aug 10, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yakima Valley Farm Workers ClinicGroup PAC ID 4385541986, 274 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Shepherd Home Health Home health agency, Hermiston, OR, CCN 387090
• Vange John Memorial Hospice Hospice, Hermiston, OR, CCN 381543
• Good Shepherd Medical Center Hospital, Hermiston, OR, CCN 381325
• St Anthony Hospital Hospital, Pendleton, OR, CCN 381319

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Yakima Valley Farm Workers Clinic

  dba Mirasol Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Hermiston, OR
  • NPI 1427001940
  Medicare reassignment Care Compare group
• Yakima Valley Farm Workers Clinic

  dba Lancaster Medical at Lancaster

  • Federally Qualified Health Center (FQHC)
  • Salem, OR
  • NPI 1255877858
  NPD
• Yakima Valley Farm Workers Clinic

  dba Community Health Center of Clatskanie

  • Federally Qualified Health Center (FQHC)
  • Clatskanie, OR
  • NPI 1578000345
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Commonspirit Oregon

  dba St Anthony Hospital

  • Critical Access Hospital
  • Pendleton, OR
  • NPI 1649276734
  Care Compare affiliation
• Good Shepherd Health Care System

  dba Good Shepherd Medical Center

  • Critical Access Hospital
  • Hermiston, OR
  • NPI 1295789667
  Care Compare affiliation
• Good Shepherd Health Care System

  dba Vange John Memorial Hospice

  • Community Based Hospice Care Agency
  • Hermiston, OR
  • NPI 1346295029
  Care Compare affiliation
• Good Shepherd Health Care System

  dba Good Shepherd Home Health Agency

  • Home Health Agency
  • Hermiston, OR
  • NPI 1902849375
  Care Compare affiliation

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1336693605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8030",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7512 MORRO RD",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934224404",
            "telephone_number": "805-792-1400",
            "fax_number": "805-792-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA68366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tnickerson13060@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "589 NW 11th St",
            "city": "Hermiston",
            "state": "OR",
            "country_code": "US",
            "postal_code": "978386600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Terry Newman
• Kristin L. Newsom, DDS, MS, INC.
• Ryan Ngan, PTA
• Aivy Ngo
• Huy Harry Nguyen, RPH
• Monty Lane Nielsen, D.C.
• April Machelle Nolan, M.ED., CCC-SLP
• Brandi Stotler Norico, FNP-C
• Jacquelyn Norris, M.A.
• North County Physical Therapy, Inc

• Physician Assistant in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.