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General NPI Number Information
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NPI Number | 1538380209
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Entity Type | Individual
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Provider Name | MS. JACQUELINE HILL
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/10/2009
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Provider Practice Location Address
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Address Line | 6630 S VAN NESS AVE
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City | LOS ANGELES
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State | CA
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Zip | 90047-1650
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Country | US
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Telephone | 323-565-2043
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Fax | 323-565-2044
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Provider Business Mailing Address
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Address Line | 11307 S. STANFORD AVE.
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City | LOS ANGELES
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State | CA
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Zip | 90059
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Country | US
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Telephone | 323-242-7436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 197099000
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License Number State | CA
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