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Johnny Tillis
NPI 1528606829 · on the registry since 2019
Practice
- Address
- 9412 Big Horn Blvd Ste 6
Elk Grove, CA 95758 - Phone
- (916) 879-2574
- Organisation at this address
- Tai Healthcare Llc
Another Choice Another Chance
River Oak Center For Children
River Oak Center For Children
River Oak Center For ChildrenInferred from a shared address, not stated in the registry. - Clinicians at this address
- 263
Additional practice sites
- 9343 Tech Center Dr, Sacramento, CA
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Also registered as
- 101Y00000X
- Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-09-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California