Healthcare Provider Details

I. General information

NPI: 1962521963
Provider Name (Legal Business Name): PATRICIA L TILLEMANS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 N A ST
OXNARD CA
93030-4309
US

IV. Provider business mailing address

648 E HEMLOCK ST
OXNARD CA
93033-3710
US

V. Phone/Fax

Practice location:
  • Phone: 805-236-0277
  • Fax: 805-988-6009
Mailing address:
  • Phone: 805-236-0277
  • Fax: 805-483-1907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 14203
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY 14203
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY 14203
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 14203
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY 14203
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY 14203
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberPSY 14203
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCS 8507
License Number StateCA
# 9
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 8507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: