Tiniya Brandy Lacy, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95039016 Issued in CA

Practice address

18522 US Highway 18 Ste 102
Apple Valley, CA 92307-2321

Phone

(760) 242-7707

Fax

(760) 242-1133

NPI assigned

Aug 14, 2024

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

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optima Health CorpGroup PAC ID 3779911466, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Optima Health Corp

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1245892066
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1649002064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11797 FOREST PARK LN",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923920428",
            "telephone_number": "760-662-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18522 US HIGHWAY 18 STE 102",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072321",
            "telephone_number": "760-242-7707",
            "fax_number": "760-242-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "TINIYA",
        "middle_name": "BRANDY",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95046480",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95039016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesley Kwasnicke
• Joe Yosup Kwon, M.D.
• Tracey Renee L'Heureux, RN
• Aida Labrada, ACSW
• Melinda D. Labuguen, MD
• Fatima Lagunas Torres
• Lavina Husenibhai Lakdawala, M.D.
• Lakes Physical Therapy, PC
• Carol Lam, P.A.-C.
• Daisie Cagan Lambert

• Nurse Practitioner in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.