| Doctor Name: | MS. SHYLEE BAUTISTA TIAMSON |
| NPI Number: | 1053779322 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 95003772 |
| Business Practice Address: | 255 W 5th St Apt 818 San Pedro, CA - 907313398 |
| Business Phone Number: | 3102920117 |
| Business Fax Number: | |
| Mailing Address: | 255 W 5th St Apt 818, SAN PEDRO |
| State: | CA |
| Postal Code: | 907313398 |
| Phone Number: | 3102920117 |
| Fax Number: | |
| NPI Enumeration Date: | 02/02/2016 |
| NPI Last Update Date: | 02/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 95003772 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |