Healthcare Provider Details

I. General information

NPI: 1568657187
Provider Name (Legal Business Name): MARI VALERIE HILL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 09/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 WEST 5TH STREET SUITE 550
SANTA ANA CA
92701
US

IV. Provider business mailing address

P.O. BOX 1895
SANTA ANA CA
92702
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-5015
  • Fax:
Mailing address:
  • Phone: 714-517-6318
  • Fax: 714-517-6306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN 218454
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: