Healthcare Provider Details
I. General information
NPI: 1205745361
Provider Name (Legal Business Name): HILLSIDE WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4521 SHERMAN OAKS AVE STE 101
SHERMAN OAKS CA
91403-3807
US
IV. Provider business mailing address
10201 MOUNTAIR AVE APT 303
TUJUNGA CA
91042-2653
US
V. Phone/Fax
- Phone: 424-261-9444
- Fax:
- Phone: 818-284-8589
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
CHRISTIAN
MICHAEL
VILINA
Title or Position: TRAINEE
Credential:
Phone: 424-483-0841