Healthcare Provider Details

I. General information

NPI: 1972417269
Provider Name (Legal Business Name): NILITA ESCOBAR ULLOA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 843
MILL VALLEY CA
94942-0843
US

IV. Provider business mailing address

PO BOX 843
MILL VALLEY CA
94942-0843
US

V. Phone/Fax

Practice location:
  • Phone: 415-367-5149
  • Fax: 415-388-1114
Mailing address:
  • Phone: 415-367-5149
  • Fax: 415-388-1114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number270406
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: