Individual provider Active NPI

Tiana Ann Davison

  • Physician Assistant
  • Yucaipa, CA
National Provider Identifier
1740706670
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA54993 Issued in CA
Practice address
33494 Oak Glen Rd
Yucaipa, CA 92399-2057
Phone
(909) 797-8900
NPI assigned
Aug 22, 2017
Last updated
Mar 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA54993 CA Primary

Addresses

Primary practice location

33494 Oak Glen Rd
Yucaipa, CA 92399-2057

Mailing address

254 E Fern Ave Apt 106
Redlands, CA 92373-6071
Phone (801) 664-4969

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
I20171221000154 CA Practitioner - Physician Assistant 4486912482 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
54993CAMDPharmacist
PA54993CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Singh MD a Professional Medical Corporation- Urgent Cares CurrentSince Feb 21, 2026 Accepting new patients
Southern California Emergency Medicine CurrentSince Nov 15, 2017 Accepting new patients
Southern California Emergency Medicine CurrentSince Nov 15, 2017 Accepting new patients
Cep America - California CurrentSince Oct 26, 2023 Accepting new patients
Cep America-California CurrentSince Oct 26, 2023 Accepting new patients
Cep America - California CurrentSince Oct 26, 2023 Accepting new patients
Premier Emergency Physicians of California Medical Group PC Physician Assistant Past Accepting new patients
Rainbow Basin Emergency Physicians, a Medical Corporation Physician Assistant Past Accepting new patients

Locations

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1407 Foothill Blvd
La Verne, CA 91750
Phone (909) 596-3577

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1295 Hamner Ave
Ste C
Norco, CA 92860
Phone (951) 272-6500

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

33494 Oak Glen Rd
Yucaipa, CA 92399
Phone (909) 797-8900

35193 Avenue A
Ste A
Yucaipa, CA 92399
Phone (951) 951-2762

35193 Avenue A
Ste B
Yucaipa, CA 92399

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1740706670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 E FERN AVE APT 106",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736071",
            "telephone_number": "801-664-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33494 OAK GLEN RD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992057",
            "telephone_number": "909-797-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "TIANA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA54993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

Verify at the official NPI Registry.