Healthcare Provider Details

I. General information

NPI: 1225277015
Provider Name (Legal Business Name): JULI ANN TILSNER LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 02/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

872 47TH ST
OAKLAND CA
94608-3202
US

IV. Provider business mailing address

PO BOX 14282
SAN FRANCISCO CA
94114-0282
US

V. Phone/Fax

Practice location:
  • Phone: 415-835-0663
  • Fax:
Mailing address:
  • Phone: 415-835-0663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number240
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: