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General NPI Number Information
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NPI Number | 1831378157
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Entity Type | Individual
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Provider Name | PETER EMERSON HILEN MFT
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Gender | Male
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 01/24/2011
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Provider Practice Location Address
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Address Line | 17461 IRVINE BLVD SUITE D
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City | TUSTIN
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State | CA
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Zip | 92780-3034
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Country | US
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Telephone | 949-429-9398
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Fax |
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Provider Business Mailing Address
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Address Line | 2 WHITE PELICAN LN
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City | ALISO VIEJO
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State | CA
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Zip | 92656-1225
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Country | US
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Telephone | 949-429-9398
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 47494
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License Number State | CA
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