Provider Demographics
NPI:1316494115
Name:MAOZ MEZER, HILA
Entity type:Individual
Prefix:
First Name:HILA
Middle Name:
Last Name:MAOZ MEZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 CONNEMARA WAY
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3320
Mailing Address - Country:US
Mailing Address - Phone:408-623-0554
Mailing Address - Fax:
Practice Address - Street 1:51 E CAMPBELL AVE STE 170
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2001
Practice Address - Country:US
Practice Address - Phone:408-623-0554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75975106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist