Healthcare Provider Details

I. General information

NPI: 1497192397
Provider Name (Legal Business Name): LAMISHA NICOLE HILL M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2013
Last Update Date: 05/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COUNSELING AND PSYCHOLOGICAL SERVICES TANG CTR 2222 BANCROFT WAY
BERKELEY CA
94720-0001
US

IV. Provider business mailing address

COUNSELING AND PSYCHOLOGICAL SERVICES TANG CTR 2222 BANCROFT WAY
BERKELEY CA
94720-0001
US

V. Phone/Fax

Practice location:
  • Phone: 510-642-9936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: