Provider Demographics
NPI:1467061317
Name:REYES, TIFFANY
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 REDWOOD AVE.
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-4325
Mailing Address - Country:US
Mailing Address - Phone:650-839-1076
Mailing Address - Fax:
Practice Address - Street 1:248 REDWOOD AVE.
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-4325
Practice Address - Country:US
Practice Address - Phone:650-839-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor