Healthcare Provider Details

I. General information

NPI: 1497537583
Provider Name (Legal Business Name): TIFFANY D HAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date: 10/16/2023
Reactivation Date: 01/11/2024

III. Provider practice location address

3801 MIRANDA AVE
PALO ALTO CA
94304-1207
US

IV. Provider business mailing address

733 COYOTE ST
MILPITAS CA
95035-3822
US

V. Phone/Fax

Practice location:
  • Phone: 650-391-8590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: