Provider Demographics
NPI:1588139794
Name:HILL, TAKEENYA SHONTELLE
Entity type:Individual
Prefix:MRS
First Name:TAKEENYA
Middle Name:SHONTELLE
Last Name:HILL
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 1:9805 ARAPAHO ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-5204
Mailing Address - Country:US
Mailing Address - Phone:619-607-9316
Mailing Address - Fax:
Practice Address - Street 1:4990 WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-7409
Practice Address - Country:US
Practice Address - Phone:619-668-4263
Practice Address - Fax:619-668-1665
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health