Basic Information
| Provider Information | |||||||||
| NPI: | 1831428481 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILLS | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CARSON | ||||||||
| OtherFirstName: | TERESA | ||||||||
| OtherMiddleName: | A | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3671 BUSINESS DRIVE | ||||||||
| Address2: | ST. 110 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167348396 | ||||||||
| FaxNumber: | 9167344150 | ||||||||
| Practice Location | |||||||||
| Address1: | 3671 BUSINESS DRIVE | ||||||||
| Address2: | STE. 110 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167348396 | ||||||||
| FaxNumber: | 9167344150 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/10/2009 | ||||||||
| LastUpdateDate: | 07/03/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.