Individual provider Active NPI

Uyen Phuong Tiffany Tran

  • Physician Assistant
  • Santa Maria, CA
National Provider Identifier
1750164745
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
63544 Issued in CA
Practice address
1075 E Betteravia Rd Ste 201
Santa Maria, CA 93454-7023
Phone
(805) 621-7651
NPI assigned
Aug 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 63544 CA Primary

Addresses

Primary practice location

1075 E Betteravia Rd Ste 201
Santa Maria, CA 93454-7023

Mailing address

1075 E Betteravia Rd Ste 201
Santa Maria, CA 93454-7023
Phone (805) 621-7651

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
I20240118002339 CA Practitioner - Physician Assistant 8426400151 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63544CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Dec 15, 2023 Accepting new patients
Cep America - California CurrentSince Dec 15, 2023 Accepting new patients
A.T. Still University - College for Healthy Communities CurrentSince Sep 14, 2025 Accepting new patients

Locations

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

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

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

1075 E Betteravia Rd
#201
Santa Maria, CA 93454
Phone (805) 621-7644

Organizations & group practices 5

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": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1750164745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 E BETTERAVIA RD STE 201",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547023",
            "telephone_number": "805-621-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 E BETTERAVIA RD STE 201",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547023",
            "telephone_number": "805-621-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "UYEN PHUONG",
        "middle_name": "TIFFANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "63544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.