Healthcare Provider Details

I. General information

NPI: 1609123777
Provider Name (Legal Business Name): DIANA HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ALLERTON ST
REDWOOD CITY CA
94063-1519
US

IV. Provider business mailing address

105 BRIGHTON RD
PACIFICA CA
94044-2707
US

V. Phone/Fax

Practice location:
  • Phone: 650-599-9955
  • Fax:
Mailing address:
  • Phone: 650-274-8324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15743
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: