Healthcare Provider Details

I. General information

NPI: 1215831375
Provider Name (Legal Business Name): JILLIAN CONLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 S AMPHLETT BLVD STE 300B
SAN MATEO CA
94402-2510
US

IV. Provider business mailing address

1670 S AMPHLETT BLVD STE 300B
SAN MATEO CA
94402-2510
US

V. Phone/Fax

Practice location:
  • Phone: 650-639-8312
  • Fax:
Mailing address:
  • Phone: 650-639-8312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95037078
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: