Provider Demographics
NPI:1043569528
Name:ALIOTO, JILL LEANNE (NP)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:LEANNE
Last Name:ALIOTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:JILL
Other - Middle Name:LEANNE
Other - Last Name:KENNEWEG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6555 COYLE AVE #220
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608
Mailing Address - Country:US
Mailing Address - Phone:916-241-9677
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE #220
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608
Practice Address - Country:US
Practice Address - Phone:916-241-9677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22248164W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No164W00000XNursing Service ProvidersLicensed Practical Nurse