Provider Demographics
NPI:1346825270
Name:TILLEY, XOCHITL (FNP)
Entity Type:Individual
Prefix:
First Name:XOCHITL
Middle Name:
Last Name:TILLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 W OLIVE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-3181
Mailing Address - Country:US
Mailing Address - Phone:209-383-4024
Mailing Address - Fax:209-383-5464
Practice Address - Street 1:374 W OLIVE AVE STE B
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3181
Practice Address - Country:US
Practice Address - Phone:209-383-4024
Practice Address - Fax:209-383-5464
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95016692363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily