Healthcare Provider Details

I. General information

NPI: 1043746563
Provider Name (Legal Business Name): DORIAN HILTON LCSW
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: DORIAN HARR

II. Dates (important events)

Enumeration Date: 05/03/2017
Last Update Date: 08/11/2024
Certification Date: 08/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 MISSION ST
SAN FRANCISCO CA
94103-2417
US

IV. Provider business mailing address

4810 DAISY ST APT A
OAKLAND CA
94619-2800
US

V. Phone/Fax

Practice location:
  • Phone: 415-565-7667
  • Fax:
Mailing address:
  • Phone: 510-863-0359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number84557
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number84557
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number108408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: