Kimberly Lavonne Tillman

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

6601-R Issued in CA

Practice address

982 Mission St
San Francisco, CA 94103-2911

Phone

(415) 624-3689

NPI assigned

Jul 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1831612407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "982 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032911",
            "telephone_number": "415-624-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032911",
            "telephone_number": "415-624-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "KIMBERLY",
        "middle_name": "LAVONNE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "6601-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaka Tilghman
• Adrian Tiller, M.F.T.
• Michael Thomas Tiller, D.D.S.
• Shelli Z Tiller, M.D.
• Myranda Tillis, PHARMD
• Drew Carter Tillotson
• Monica Tilly
• Beverly Diane Tilson, LAADC-CA LCI2361214
• Charlotte Tilson, PSY.D.
• Shannon Crystal Amber Tilston

• 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 Oct 25, 2019; 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.