Provider Demographics
NPI:1699479915
Name:TUCK, HILLARY ANNE (LMFT)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:ANNE
Last Name:TUCK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7381 W 83RD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-2446
Mailing Address - Country:US
Mailing Address - Phone:310-922-8801
Mailing Address - Fax:
Practice Address - Street 1:3301 OCEAN PARK BLVD STE 206
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-3230
Practice Address - Country:US
Practice Address - Phone:323-705-3531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103277106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist