Active NPI
Tinley Anne Ireland
- Physician Assistant
- Vallejo, CA
National Provider Identifier
1821702606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 67050
- Practice address
- 1310 Club Dr
Vallejo, CA 94592-1187 - Phone
- (707) 638-5809
- NPI assigned
- Jan 6, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 67050 | CA | Primary |
Addresses
Primary practice location
1310 Club Dr
Vallejo, CA 94592-1187
Mailing address
3000 Webb St
Vallejo, CA 94591-5539
Phone (916) 316-5472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260108000702 | CA | Order and Referring Only - Physician Assistant | 0840776019 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776902400000",
"number": "1821702606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 WEBB ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945915539",
"telephone_number": "916-316-5472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 CLUB DR",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945921187",
"telephone_number": "707-638-5809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRELAND",
"first_name": "TINLEY",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-06",
"last_updated": "2026-04-23",
"certification_date": "2026-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "67050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.