Healthcare Provider Details

I. General information

NPI: 1689081358
Provider Name (Legal Business Name): SOPHIA HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2014
Last Update Date: 07/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15942 FOOTHILL BLVD
SAN LEANDRO CA
94578-2102
US

IV. Provider business mailing address

8750 MOUNTAIN BLVD # 69
OAKLAND CA
94605-4500
US

V. Phone/Fax

Practice location:
  • Phone: 510-317-1444
  • Fax:
Mailing address:
  • Phone: 510-777-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: