Healthcare Provider Details

I. General information

NPI: 1124524186
Provider Name (Legal Business Name): HILARY SIBILIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 3RD AVE STE 101
CHULA VISTA CA
91911-1349
US

IV. Provider business mailing address

865 3RD AVE STE 101
CHULA VISTA CA
91911-1349
US

V. Phone/Fax

Practice location:
  • Phone: 619-426-7910
  • Fax: 619-426-2337
Mailing address:
  • Phone: 619-426-7910
  • Fax: 619-426-2337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number95007080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: