Provider Demographics
NPI:1306281365
Name:HILL, BROCKTON DAVID (JD,MA,MFT)
Entity type:Individual
Prefix:MR
First Name:BROCKTON
Middle Name:DAVID
Last Name:HILL
Suffix:
Gender:M
Credentials:JD,MA,MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 S EUCLID AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2446
Mailing Address - Country:US
Mailing Address - Phone:818-726-1459
Mailing Address - Fax:
Practice Address - Street 1:130 S EUCLID AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2446
Practice Address - Country:US
Practice Address - Phone:818-726-1459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-05
Last Update Date:2013-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT37755102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst