Provider Demographics
NPI:1194970541
Name:HILL, ERYNNE NICOLE (MS, HHP, ATC, LMT)
Entity type:Individual
Prefix:
First Name:ERYNNE
Middle Name:NICOLE
Last Name:HILL
Suffix:
Gender:F
Credentials:MS, HHP, ATC, LMT
Other - Prefix:
Other - First Name:ERYNNE
Other - Middle Name:NICOLE
Other - Last Name:BROTHERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HHP, ATC, LMT
Mailing Address - Street 1:3959 RUFFIN RD
Mailing Address - Street 2:STE F
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1830
Mailing Address - Country:US
Mailing Address - Phone:858-279-5570
Mailing Address - Fax:858-279-5303
Practice Address - Street 1:3959 RUFFIN RD STE J
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1830
Practice Address - Country:US
Practice Address - Phone:858-279-5570
Practice Address - Fax:858-279-5303
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA07003020225700000X
TN0702022542255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist