Healthcare Provider Details

I. General information

NPI: 1043139504
Provider Name (Legal Business Name): TIFFANY SHEPPARD, LICENSED MARRIAGE AND FAMILY THERAPIST, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2212 F ST
BAKERSFIELD CA
93301-3828
US

IV. Provider business mailing address

2212 F ST
BAKERSFIELD CA
93301-3828
US

V. Phone/Fax

Practice location:
  • Phone: 661-484-6579
  • Fax: 661-325-2031
Mailing address:
  • Phone: 661-484-6579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY SHEPPARD
Title or Position: CEO
Credential: LMFT
Phone: 661-484-6579