Individual provider Active NPI

Tiffany Baca

  • Social Worker
  • San Dimas, CA
National Provider Identifier
1710440292
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
118825 Issued in CA
Practice address
180 Via Verde Ste 200
San Dimas, CA 91773-3993
Phone
(909) 599-1227
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Social Worker 104100000X 118825 CA Primary
Behavior Technician 106S00000X CA
Mental Health Counselor 101YM0800X 118825 CA

Addresses

Primary practice location

180 Via Verde Ste 200
San Dimas, CA 91773-3993

Mailing address

PO Box 92225
City of Industry, CA 91715-2225
Phone (206) 379-1687

Other practice location 1

2008 N Garey Ave
Pomona, CA 91767-2722
Phone (909) 623-6131

Other practice location 2

2008 N Garey Ave
Pomona, CA 91767-2722
Phone (909) 623-6131

Other practice location 3

4590 Allstate Dr
Riverside, CA 92501-1702
Phone (909) 599-1227

Other practice location 4

1520 N Raymond Ave
Pasadena, CA 91103-1819
Phone (626) 396-5920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
118825CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Mental Health Authority CurrentSince Oct 1, 2020 Accepting new patients
Tri-City Mental Health Center PastSince Oct 1, 2020 Accepting new patients
Pasadena Unified School District PastSince Sep 1, 2022 Accepting new patients

Locations

2008 N Garey Ave
Pomona, CA 91767
Phone (909) 242-7640

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1710440292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92225",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917152225",
            "telephone_number": "206-379-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 VIA VERDE STE 200",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733993",
            "telephone_number": "909-599-1227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2008 N Garey Ave",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917672722",
            "country_code": "US",
            "telephone_number": "909-623-6131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2008 N Garey Ave",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917672722",
            "country_code": "US",
            "telephone_number": "909-623-6131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4590 Allstate Dr",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925011702",
            "country_code": "US",
            "telephone_number": "909-599-1227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1520 N Raymond Ave",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911031819",
            "country_code": "US",
            "telephone_number": "626-396-5920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACA",
        "first_name": "TIFFANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "118825",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "118825",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.