Individual provider · Type 1 NPI
Dierdre A. Gilliam, MSN, RN, PHN
Administrator Registered Nurse · Woodland, CA
NPI number
1205984010
Active
Practice location
137 N Cottonwood St, Ste 2400
Woodland, CA 95695
Fax (530) 666-7447
Mailing address
8425 Fernando Way
Elverta, CA 95626-9542
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Administrator Registered Nurse Primary | 163WA2000X | 607502 (CA) |
| Community Health Registered Nurse | 163WC1500X | 607502 (CA) |
Administrator Registered Nurse: Definition to come...
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About NPI 1205984010
Dierdre A. Gilliam, MSN, RN, PHN's National Provider Identifier is 1205984010, issued on Jan 8, 2007. The primary taxonomy on file is Administrator Registered Nurse (163WA2000X), and the practice location is in Woodland, CA. The record was last updated on Sep 11, 2025.