Gillis, Kathleen Jan

Gillis, Kathleen Jan is an individual health care provider with primary practice located at 3100 Telegraph Ave Suite 2102, Oakland CA 94609-3210. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Gillis, Kathleen Jan can be contacted via phone (510) 286-8160.

Contact Information

Primary practice address
3100 Telegraph Ave Suite 2102 Oakland CA 94609-3210
Phone: (510) 286-8160
Fax: (510) 286-8158
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN289570 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 7266 California

Profile Details

NPI number 1750354882
LBN Legal business name Gillis, Kathleen Jan
Credentials RN MSN FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Apr 23rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750354882 NPPES
California MEDICAID GR0028630

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