Provider Demographics
NPI:1760813679
Name:FLOWERDAY, TIFFANY PAIGE (MFT)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:PAIGE
Last Name:FLOWERDAY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 ANITA DR
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-1624
Mailing Address - Country:US
Mailing Address - Phone:408-364-5816
Mailing Address - Fax:
Practice Address - Street 1:480 ANITA DR
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-1624
Practice Address - Country:US
Practice Address - Phone:408-364-5816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80079101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health