MEDICARE: TIFFANY STRAUGHTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	500550	CA

General Provider Information

NPI Number	:	1174481360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY STRAUGHTER

Provider Business Mailing Address
First Line	:	PO BOX 931
Second Line	:
City	:	PINOLE
State	:	CA
Zip	:	94564-0931
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3645 SAN PABLO DAM RD
Second Line	:
City	:	EL SOBRANTE
State	:	CA
Zip	:	94803-2729
Country	:	US
Telephone Number	:	510-318-7510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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Directions to “ TIFFANY STRAUGHTER ” Practice Location

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