Tiffany Joy Mallick, ATC

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

5092 Oak Bend Dr
La Verne, CA 91750-1512

Phone

(909) 973-7888

NPI assigned

May 31, 2016

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

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1497103543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5092 OAK BEND DR",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917501512",
            "telephone_number": "909-973-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5092 OAK BEND DR",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917501512",
            "telephone_number": "909-973-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLICK",
        "first_name": "TIFFANY",
        "middle_name": "JOY",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Ma, COTA/L
• Heather Elizabeth Machen-Porter
• Melissa Magallanes, PSY.D.
• Heather Nichol Maglothin
• Isabel Teresa Maldonado
• Casey Mamora, OTR/L
• Sadiq Mandilawi, MD
• Jessica Andrea Marca, MSW
• Mallory Kai Marin
• Deanne Marino, LCSW

• Specialist in La Verne, CA
• Providers in La Verne, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.