Provider Demographics
NPI:1417617580
Name:DHILLON, JAMIE LYNN (MSN, CNS, AGNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LYNN
Last Name:DHILLON
Suffix:
Gender:F
Credentials:MSN, CNS, AGNP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1544 RANCHO DEL HAMBRE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-2316
Mailing Address - Country:US
Mailing Address - Phone:415-816-8774
Mailing Address - Fax:
Practice Address - Street 1:1261 TRAVIS BLVD STE 320
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4800
Practice Address - Country:US
Practice Address - Phone:707-423-2506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA3170364SA2200X
CA95023752363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health