Shannon Crystal Amber Tilston

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2441 Jackson St
San Francisco, CA 94115-1324

Phone

(415) 345-6380

Fax

(415) 346-1058

NPI assigned

Feb 6, 2009

Last updated

Feb 6, 2009By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Conard House Jackson Street Residential Program

  • Psychiatric Residential Treatment Facility
  • San Francisco, CA
  • NPI 1588860977
  NPD (past)

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233878400000",
    "number": "1578702064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "773 SAN JOSE AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941104915",
            "telephone_number": "415-812-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 JACKSON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151324",
            "telephone_number": "415-345-6380",
            "fax_number": "415-346-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILSTON",
        "first_name": "SHANNON",
        "middle_name": "CRYSTAL AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-06",
        "last_updated": "2009-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Lavonne Tillman
• Drew Carter Tillotson
• Monica Tilly
• Beverly Diane Tilson, LAADC-CA LCI2361214
• Charlotte Tilson, PSY.D.
• Kai K Tiltmann, D.C.
• Nicole Marie Tilton, C.P.N.P
• Timberlake Forrest Inc (Sheffield Convalescent Hospital)
• Clare Timbie
• Ashley Leathers Timbrell, LCSW

• Mental Health Counselor in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; 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.