Provider Demographics
NPI:1114405917
Name:LEM, TIFFANY KAI-ERH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:KAI-ERH
Last Name:LEM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:TIFFANY
Other - Middle Name:KAI-ERH
Other - Last Name:CHEUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:4305 SUNSET VIEW DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-6708
Mailing Address - Country:US
Mailing Address - Phone:510-909-2670
Mailing Address - Fax:
Practice Address - Street 1:4305 SUNSET VIEW DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-6708
Practice Address - Country:US
Practice Address - Phone:510-909-2670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19893235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist