Drew Carter Tillotson

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY16651 Issued in CA

Practice address

1730 Divisadero St
San Francisco, CA 94115-3012

Phone

(415) 551-7970

NPI assigned

Nov 22, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mr. Drew Carter Tillotson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1255098430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 PLYMOUTH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121240",
            "telephone_number": "415-845-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 DIVISADERO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153012",
            "telephone_number": "415-551-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLOTSON",
        "first_name": "DREW",
        "middle_name": "CARTER",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY16651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DREW",
            "last_name": "TILLOTSON",
            "middle_name": "CARTER",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adrian Tiller, M.F.T.
• Michael Thomas Tiller, D.D.S.
• Shelli Z Tiller, M.D.
• Myranda Tillis, PHARMD
• Kimberly Lavonne Tillman
• Monica Tilly
• Beverly Diane Tilson, LAADC-CA LCI2361214
• Charlotte Tilson, PSY.D.
• Shannon Crystal Amber Tilston
• Kai K Tiltmann, D.C.

• Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.