MICHELLE TILLEY (NPI# 1093160533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093160533 |
| Entity Type | Individual |
| Full Name | MICHELLE TILLEY |
| Credential | NP |
| Practice Address |
5717 Pacific Center Blvd Ste 200 San Diego CA 92121-4250 |
| Practice Telephone | 8588591188 |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2019-05-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 720762 | CA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
23391 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364S00000X | Clinical Nurse Specialist | 3647 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9300 Valley Childrens Place, Neurosurgery, Madera, CA 936368761 | 5593536277 |
| Street Address |
5717 PACIFIC CENTER BLVD STE 200 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-4250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629000104 | Laurie Eastwood Raher | Nurse Practitioner | 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121-4250 | 2006-07-07 |
| 1053881235 | Ann Crane Durham | Nurse Practitioner | 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121-4250 | 2018-11-29 |
| 1356852206 | Maria Cecilia Cruz Jamito | Nurse Practitioner | 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121-4250 | 2017-10-18 |
| 1083139190 | Emily Ann Lee | Nurse Practitioner | 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121-4250 | 2017-08-09 |
| 1578087029 | Jessica Daniela Welch | Nurse Practitioner | 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121 | 2017-07-26 |
| 1912420142 | Samantha Corinne Lipka Hawley | Physician Assistant | 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121-4250 | 2017-07-19 |
| 1689101362 | Allysen Kelly | Nurse Practitioner | 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121-4250 | 2017-05-12 |
| 1992231096 | Julie Whitacre | Registered Nurse | 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121 | 2017-05-10 |
| 1568997336 | Katherine Anne Cupka | Nurse Practitioner | 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121-4250 | 2017-04-28 |
| 1396277489 | Kristin Leigh Beseke | Nurse Practitioner | 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121 | 2017-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203097 | Rebecca Dolores Garcia | Nurse Practitioner | 2440 Curlew St, San Diego, CA 92101-1327 | 2020-10-20 |
| 1003415472 | Ryanleo Flores | Nurse Practitioner | 2017 1st Avenue, Suite 301, San Diego, CA 92101 | 2020-10-18 |
| 1083226245 | Allison Floyd | Nurse Practitioner | 3652 Texas St, San Diego, CA 92104-4044 | 2020-08-19 |
| 1386255248 | Helen Hyeyoung Hong | Nurse Practitioner | 5140 Caminito Exquisito, San Diego, CA 92130-2852 | 2020-08-13 |
| 1134747595 | Dawn Elyse Rose | Nurse Practitioner | 8260 Mira Mesa Blvd Ste A, San Diego, CA 92126-2662 | 2020-07-10 |
| 1982232591 | John Meier | Nurse Practitioner | 3745 Riviera Dr Apt 10, San Diego, CA 92109-6661 | 2020-03-30 |
| 1013543008 | Alex Choi Mara | Nurse Practitioner | 5248 Zephyr Ln Unit 24, San Diego, CA 92120-2749 | 2020-03-21 |
| 1669005021 | Katlyn Ann Hartman | Nurse Practitioner | 1951 4th Ave, San Diego, CA 92101-2374 | 2020-02-13 |
| 1245876101 | Katherine Baber | Nurse Practitioner | 3671 Fifth Ave, San Diego, CA 92103-4218 | 2019-11-25 |
| 1922644095 | Taiko Harris | Nurse Practitioner | 13592 Bolero Way, San Diego, CA 92130-7006 | 2019-11-22 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.