Abrea Tillman

Primary specialty

SpecialistTaxonomy code 174400000X

License

KK588449 Issued in CA

Practice address

460 City Center Dr
Rohnert Park, CA 94928-2186

Phone

(415) 900-7489

NPI assigned

May 13, 2025

Last updated

May 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Locations

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.

• Labeautyandhair

  • Durable Medical Equipment & Medical Supplies
  • Rohnert Park, CA
  • NPI 1295284248
  NPD Authorized official

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1912798885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3558 ROUND BARN BLVD STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954030991",
            "telephone_number": "415-900-7489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 CITY CENTER DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282186",
            "telephone_number": "415-900-7489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3558 Round Barn Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954030991",
            "country_code": "US",
            "telephone_number": "415-900-7489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "ABREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "KK588449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Rohnert Park, CA
• Providers in Rohnert Park, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.