Demetra Me'Quan Tillar-Coachman, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW88439 Issued in CA

Practice address

705 Pier View Way Ste a
Oceanside, CA 92054-2848

Phone

(442) 500-8200

NPI assigned

Jan 29, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: demetratillarcoachman@tdh.allscriptsdirect.net

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.

• San Diego Psychotherapy and Wellness Center Inc.

  • Marriage & Family Therapist
  • Oceanside, CA
  • NPI 1477909331
  NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1699913640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 PIER VIEW WAY STE A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542848",
            "telephone_number": "773-971-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 PIER VIEW WAY STE A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542848",
            "telephone_number": "442-500-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLAR-COACHMAN",
        "first_name": "DEMETRA",
        "middle_name": "ME'QUAN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013964",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005666",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW88439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thrive Home Therapy LLC
• Thrive Medical Specialists, a Professional Corporation
• Thrive Physical Medicine Inc
• Roanld Gene Thurlow, PH.D. MFT
• Matalena Tili
• Linda I Tillotson, M.A.
• Stephen Paul del Rosario Tinio, M.D.
• Shaina Dawn Tiritilli, AMFT
• Isha Tirupathi
• TKT Services Inc

• Clinical Social Worker in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.