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General NPI Number Information
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NPI Number | 1659844116
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Entity Type | Individual
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Provider Name | TIFFANY MASON MA CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/08/2019
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 787 MUNRAS AVE STE 101
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City | MONTEREY
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State | CA
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Zip | 93940-3131
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Country | US
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Telephone | 831-645-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 8484 MIDDLE RUN DR
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City | SPRINGFIELD
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State | VA
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Zip | 22153-2221
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Country | US
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Telephone | 908-338-2161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202007287
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 28165
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License Number State | CA
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