# KAISER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922193556
- **Authorized official:** MS. THERESA LYNN GILLILAND NP-C (NURSE PRACTITIONER)
- **Authorized official phone:** (408) 366-4151

## Contact information

- **Practice address:** 19000 HOMESTEAD, CUPERTINO, CA 95014
- **Practice address phone:** (408) 366-4151
- **Mailing address:** PO BOX 458, POLLOCK PINES, CA 95726
- **Mailing address phone:** (530) 647-1813

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | NPF 11076 | CA | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 10/22/2008