MEDICARE: MRS. NICOLE J HILL MFT

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	106H00000X	Marriage & Family Therapist	MFC 36307	CA

General Provider Information

NPI Number	:	1568654960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NICOLE J HILL MFT

Provider Business Mailing Address
First Line	:	2719 N WOODROW AVE
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-1540
Country	:	US
Telephone Number	:	805-584-3020
Fax Number	:	805-584-5157

Provider Business Practice Location Address
First Line	:	2719 N WOODROW AVE
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-1540
Country	:	US
Telephone Number	:	805-584-3020
Fax Number	:	805-584-5157

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

Provider Enumeration Date	:	08/10/2007
Last Update Date	:	12/18/2018

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