TATJANA ILICH

VISTA, CA
NPI1316627151
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
(Licence: CA  95026030)
Additional Taxonomies163WM0705X Registered Nurse, Medical-Surgical
(Licence: CA  95165114)
363LF0000X Nurse Practitioner, Family
(Licence: CA  95026030)
Enumeration Date2023-07-18
Last Update Date2023-07-18
Business Address
TATJANA ILICH NP
1185 BEVERLY DR
VISTA, CA 92084-4705
Phone number: 760-685-3306
Mailing Address
TATJANA ILICH NP
1185 BEVERLY DR
VISTA, CA 92084-4705
Phone number: 760-685-3306