Healthcare Provider Details

I. General information

NPI: 1912615808
Provider Name (Legal Business Name): KERRIE LYNNE HILLHOUSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12141 BROOKHURST ST STE 101
GARDEN GROVE CA
92840-2865
US

IV. Provider business mailing address

8582 PYLE WAY
MIDWAY CITY CA
92655-1142
US

V. Phone/Fax

Practice location:
  • Phone: 714-296-1934
  • Fax:
Mailing address:
  • Phone: 714-230-5212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: