Provider Demographics
NPI:1619524501
Name:TRIPLETT, TIFFANY (MA, LMFT, APCC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:MA, LMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10531 4S COMMONS DR STE 166-670
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-3517
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10531 4S COMMONS DR STE 166-670
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-3517
Practice Address - Country:US
Practice Address - Phone:619-885-9006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-25
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95568106H00000X
CA123272106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist