Provider Demographics
NPI:1568654960
Name:HILL, NICOLE J (MFT)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:J
Last Name:HILL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 N WOODROW AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1540
Mailing Address - Country:US
Mailing Address - Phone:805-584-3020
Mailing Address - Fax:805-584-5157
Practice Address - Street 1:2719 N WOODROW AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1540
Practice Address - Country:US
Practice Address - Phone:805-584-3020
Practice Address - Fax:805-584-5157
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 36307106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist