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TIFFANY AMBER NICKENS PA-C
NPI 1386136778
Physician Assistant - Medical in Redway, CA

Active since June 01, 2018
101 WEST COAST RD, #B, REDWAY, CA 95560(707) 923-2783 Get Directions Write a Review

NPPES record last updated: September 23, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 21, 2024, Aug 19, 2021, Sep 24, 2020 and 1 more (4 updates tracked since 2019).

About Tiffany Amber Nickens Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIFFANY AMBER NICKENS PA-C (NPI 1386136778) is an individual medical provider in Redway, California, licensed in California (62762) and active in the NPI registry since June 2018. She maintains a secondary practice location in Chevy Chase.

NPPES Registry Identity

NPI1386136778
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameTIFFANY AMBER NICKENSCredential: PA-C
Location Address101 WEST COAST RD, #BRedway, CA 95560
Mailing Address8401 Connecticut Ave Ph SuiteChevy Chase, MD 20815-5822 · (301) 942-2212 · Fax (301) 942-1149
Phone(707) 923-2783
Sole ProprietorNo
Enumeration DateJune 1, 2018
Last NPPES UpdateSeptember 23, 20254 updates tracked since enumeration
NPPES CertifiedSeptember 23, 2025
✔ NPI 1386136778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CA · 62762
101 WEST COAST RD, Redway, CA 95560
Open in Google Maps ↗

Secondary Practice Location 1

Location 18401 Connecticut Ave Ph SuiteChevy Chase, MD 20815-5822 · Phone (301) 942-2212 · Fax (301) 942-1149

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MORGAN DANIELLE HINES
Physician Assistant (Medical)
101 WEST COAST RD, B
REDWAY, CA 95560
Humboldt County (707) 923-2783
MEGAN MCCORMACK HYGIENTIST
Dental Hygienist
101 WEST COAST RD
REDWAY, CA 95560
Humboldt County (707) 923-2783
MAXWELL THEODORE DISMUKE DDS
Dentist
101 WEST COAST RD
REDWAY, CA 95560
Humboldt County (707) 923-2783
REDWOODS RURAL HEALTH CENTER, INC.
Non-emergency Medical Transport (VAN)
101 WEST COAST RD
REDWAY, CA 95560
Humboldt County (707) 923-2783
JAMES HOLLAND
Social Worker (Clinical)
101 WEST COAST RD
REDWAY, CA 95560
Humboldt County (707) 923-2783
MS. MARILYN LEE FOOTE LCSW
Social Worker
101 WEST COAST RD
REDWAY, CA 95560
Humboldt County (707) 923-2783
DR. RONALD JOHN KEHL DDS
Dentist
101 WEST COAST RD
REDWAY, CA 95560
Humboldt County (707) 923-2783
JAMI JOHNSON L.M.
Midwife
101 WEST COAST RD
REDWAY, CA 95560
Humboldt County (707) 923-2783

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiffany Nickens's NPI number?

The NPI number for Tiffany Nickens is 1386136778. It was assigned to this individual provider in the NPPES registry on June 1, 2018.

Where is Tiffany Nickens located?

Tiffany Nickens practices at 101 West Coast Rd #b, Redway, CA 95560. The listed phone number is (707) 923-2783.

What is Tiffany Nickens's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Tiffany Nickens was last updated on September 23, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.