Provider Demographics
NPI:1316833759
Name:SANCHEZ, TIFFANY SHANIAH
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:SHANIAH
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 336
Mailing Address - Street 2:
Mailing Address - City:TIERRA AMARILLA
Mailing Address - State:NM
Mailing Address - Zip Code:87575-0336
Mailing Address - Country:US
Mailing Address - Phone:575-588-7350
Mailing Address - Fax:
Practice Address - Street 1:2 MAIN ST. BLDG 2
Practice Address - Street 2:
Practice Address - City:TIERRA AMARILLA
Practice Address - State:NM
Practice Address - Zip Code:87575-0336
Practice Address - Country:US
Practice Address - Phone:575-588-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator