Alicia Tiedra

Primary specialty

Social WorkerTaxonomy code 104100000X

License

95441 Issued in CA

Practice address

456 Elm Ave
Long Beach, CA 90802-2426

Phone

(562) 437-6717

Fax

(562) 437-5072

NPI assigned

Oct 4, 2016

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1447700356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 ELM AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908022426",
            "telephone_number": "562-437-6717",
            "fax_number": "562-437-5072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 ELM AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908022426",
            "telephone_number": "562-437-6717",
            "fax_number": "562-437-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDRA",
        "first_name": "ALICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "95441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tichenor Lowman Miller Medical Group Inc
• Sarah Elizabeth Tickfer, PT, DPT
• Cheyenna Tidwell
• Milleon Tidwell
• Sarah Elizabeth Tidwell
• Shawn Patrick Tierney, D.C.
• Dorianne Tillano, NP- C
• Dion Lee Tillman
• Rosemary Tilmon-Kellum, PA-C
• Penny R Timmen, LCSW

• Social Worker in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.

Verify at the official NPI Registry.