Provider Demographics
NPI:1295483519
Name:SCHOFIELD, TIFFANY ANN
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANN
Last Name:SCHOFIELD
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 1:707 FAIR AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-5828
Mailing Address - Country:US
Mailing Address - Phone:831-427-1007
Mailing Address - Fax:831-454-0545
Practice Address - Street 1:1051B CORTO SAN MIGUEL
Practice Address - Street 2:
Practice Address - City:ROYAL OAKS
Practice Address - State:CA
Practice Address - Zip Code:95076-9150
Practice Address - Country:US
Practice Address - Phone:682-557-4621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)