Individual provider Active NPI

Tiffany Nguyen Segura, DPT

  • Physical Therapist
  • San Jose, CA
National Provider Identifier
1902689441
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
304603 Issued in CA
Practice address
5190 Shadow Est
San Jose, CA 95135-1229
Phone
(714) 330-1599
NPI assigned
Aug 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 304603 CA Primary

Addresses

Primary practice location

5190 Shadow Est
San Jose, CA 95135-1229

Mailing address

5190 Shadow Est
San Jose, CA 95135-1229
Phone (714) 330-1599

Other names 1

  • Tiffany Nguyen Raczynski Former name

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
304603CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1902689441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 SHADOW EST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351229",
            "telephone_number": "714-330-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 SHADOW EST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351229",
            "telephone_number": "714-330-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGURA",
        "first_name": "TIFFANY",
        "middle_name": "NGUYEN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "RACZYNSKI",
            "middle_name": "NGUYEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.