MEDICARE: MRS. AMANDA JEAN HILL MS, ATC, PES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1063612794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA JEAN HILL MS, ATC, PES

Provider Business Mailing Address
First Line	:	1792 E RYAN LN
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-4058
Country	:	US
Telephone Number	:	559-273-5999
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 OAK RD
Second Line	:	#122
City	:	WALNUT CREEK
State	:	CA
Zip	:	94597-7708
Country	:	US
Telephone Number	:	559-259-1944
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2007
Last Update Date	:	11/10/2014

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