Tatjana Ilich, NP
Nurse Practitioner, Primary Care in Vista, CA. Individual provider (NPI-1).
NPI number1316627151
StatusActive
Last updated in NPPESFeb 5, 2026
Details
- NPI
- 1316627151
- Entity type
- Individual (NPI-1)
- Name
- Tatjana Ilich
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 18, 2023
- Certification date
- Feb 5, 2026
- Last updated
- Feb 5, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | 95026030 | CA | Yes |
| 363LF0000X | Nurse Practitioner, Family | 95026030 | CA | |
| 163WM0705X | Registered Nurse, Medical-Surgical | 95165114 | CA |
Practice location
1964 Via CtrVista, CA 92081-6056
Phone 888-743-7526
Mailing address
1964 Via CtrVista, CA 92081-6056
Phone 888-743-7526
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