Beverly Diane Tilson, LAADC-CA LCI2361214

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCI2361214 Issued in CA

Practice address

101 Gough St
San Francisco, CA 94102

Phone

(415) 553-3252

NPI assigned

May 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1396946877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GOUGH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025903",
            "telephone_number": "415-553-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 GOUGH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94102",
            "telephone_number": "415-553-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILSON",
        "first_name": "BEVERLY",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LAADC-CA LCI2361214",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "LCI2361214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAARR",
            "identifier": "03-068218",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelli Z Tiller, M.D.
• Myranda Tillis, PHARMD
• Kimberly Lavonne Tillman
• Drew Carter Tillotson
• Monica Tilly
• Charlotte Tilson, PSY.D.
• Shannon Crystal Amber Tilston
• Kai K Tiltmann, D.C.
• Nicole Marie Tilton, C.P.N.P
• Timberlake Forrest Inc

• Addiction (Substance Use Disorder) Counselor in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.