Provider Demographics
NPI:1568071124
Name:COLEMAN, ILIANA Q (RN)
Entity type:Individual
Prefix:MISS
First Name:ILIANA
Middle Name:Q
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 HITCHCOCK WAY STE B170
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4016
Mailing Address - Country:US
Mailing Address - Phone:805-845-4455
Mailing Address - Fax:
Practice Address - Street 1:351 HITCHCOCK WAY STE B170
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4016
Practice Address - Country:US
Practice Address - Phone:805-845-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95125916163W00000X
CA95033554363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse