Provider Demographics
NPI:1073063517
Name:HILL, ROCKFORD
Entity Type:Individual
Prefix:
First Name:ROCKFORD
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82165 DOCTOR CARREON BLVD
Mailing Address - Street 2:APT 5D2
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-4826
Mailing Address - Country:US
Mailing Address - Phone:442-269-9703
Mailing Address - Fax:
Practice Address - Street 1:82165 DOCTOR CARREON BLVD
Practice Address - Street 2:APT 5D2
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-4826
Practice Address - Country:US
Practice Address - Phone:442-269-9703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician