Provider Demographics
NPI:1184319212
Name:TILAHUN, GELILA (NP)
Entity type:Individual
Prefix:
First Name:GELILA
Middle Name:
Last Name:TILAHUN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 E WILLOW ST UNIT 202
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-6321
Mailing Address - Country:US
Mailing Address - Phone:562-673-1963
Mailing Address - Fax:
Practice Address - Street 1:2514 E WILLOW ST UNIT 202
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-6321
Practice Address - Country:US
Practice Address - Phone:562-673-1963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95252909163WP0808X
CA95032771363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health