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: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S AMPHLETT BLVD STE 120
SAN MATEO CA
94402-2711
US

IV. Provider business mailing address

1700 S AMPHLETT BLVD STE 120
SAN MATEO CA
94402-2711
US

V. Phone/Fax

Practice location:
  • Phone: 650-683-2428
  • Fax:
Mailing address:
  • Phone: 650-683-2428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15743
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number15743
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: