Healthcare Provider Details

I. General information

NPI: 1114859634
Provider Name (Legal Business Name): TIFFANY BUI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7812 EDINGER AVE
HUNTINGTON BEACH CA
92647-3727
US

IV. Provider business mailing address

17361 JUNIPER LN
HUNTINGTON BEACH CA
92649-4575
US

V. Phone/Fax

Practice location:
  • Phone: 714-916-0641
  • Fax:
Mailing address:
  • Phone: 714-788-7149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number8935
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: