Individual provider Active NPI

Tiffany Leung, RD

  • Registered Dietitian
  • Stockton, CA
National Provider Identifier
1467219915
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86359588 Issued in CA
Practice address
2349 N California St
Stockton, CA 95204-5505
Phone
(209) 469-2229
NPI assigned
Mar 1, 2024
Last updated
Mar 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86359588 CA Primary

Addresses

Primary practice location

2349 N California St
Stockton, CA 95204-5505

Mailing address

2349 N California St
Stockton, CA 95204-5505
Phone (209) 469-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240520003233 CA Practitioner - Registered Dietitian Or Nutrition Professional 6406298637 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86359588CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Centers, Inc. Current Accepting new patients
Community Medical Centers Inc CurrentSince Mar 23, 2024 Accepting new patients
Community Medical Centers Inc CurrentSince Mar 23, 2024 Accepting new patients

Locations

1031 Waterloo Rd
Stockton, CA 95205
Phone (209) 940-5600

2349 N California St
Stockton, CA 95204
Phone (209) 469-2229

7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816

730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500

Interoperability endpoints

  • Direct secure messaging: tiffany.leung.p1@direct.cmcentersinc.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1467219915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045505",
            "telephone_number": "209-469-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045505",
            "telephone_number": "209-469-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "TIFFANY",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86359588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.