Individual provider Active NPI

Tiffany L Laffen, NP

  • Acute Care Nurse Practitioner
  • Huntington Beach, CA
National Provider Identifier
1619475381
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95008447 Issued in CA
Practice address
18800 Main St Ste 103
Huntington Beach, CA 92648-1717
Phone
(714) 842-8100
Fax
(310) 325-8109
NPI assigned
Jan 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 95008447 CA
Acute Care Nurse Practitioner 363LA2100X 95008447 CA Primary

Addresses

Primary practice location

18800 Main St Ste 103
Huntington Beach, CA 92648-1717

Mailing address

1360 W 6TH Street
Suite 200
San Pedro, CA 90732
Phone (310) 781-1414

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180425000904 CA Practitioner - Nurse Practitioner 1254695349 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95008447CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
California Heart Specialists Inc CurrentSince Nov 13, 2019 Accepting new patients

Locations

18800 Main St
Ste 103
Huntington Beach, CA 92648
Phone (714) 842-8100

18685 Main St
#101616
Huntington Beach, CA 92648

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1619475381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 W 6TH STREET",
            "address_2": "SUITE 200",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "90732",
            "telephone_number": "310-781-1414",
            "fax_number": "310-781-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18800 MAIN ST STE 103",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481717",
            "telephone_number": "714-842-8100",
            "fax_number": "310-325-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFFEN",
        "first_name": "TIFFANY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CA",
            "license": "95008447",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95008447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.