Tiffany Maynard, CPO

Primary specialty

OrthotistTaxonomy code 222Z00000X

License

CPO1893 Issued in CA

Practice address

1920 E Katella Ave Ste I
Orange, CA 92867-5149

Phone

(714) 639-7422

NPI assigned

Jul 8, 2021

Last updated

Jul 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tiffany Fong Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1932770161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 E KATELLA AVE STE I",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 E KATELLA AVE STE I",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675149",
            "telephone_number": "714-639-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "TIFFANY",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "CA",
            "license": "CPO1893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "1518909019",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Orange",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1920 E Katella Ave Ste I",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928675149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "FONG",
            "credential": "CPO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Salomon M. Maya, MD
• Laurel Mieko Song Mayeda, ASW
• Samuel Osamu Mayeda, MD
• Scott A. Mayfield, MD
• Nicole Paige Maynard, MD
• Elizabeth Mayo
• Corrine Briana Mayol, DPT
• Janeth Mayoral
• Jonathan Nicholas Mayoral
• Evelyn Mayorga

• Orthotist in Orange, CA
• Providers in Orange, CA by specialty
• Orthotist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.