Provider Demographics
NPI:1164076626
Name:ANDERSON, HILARY ABBOTT (PA-C)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:ABBOTT
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2477 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-4712
Mailing Address - Country:US
Mailing Address - Phone:805-296-2838
Mailing Address - Fax:
Practice Address - Street 1:8340 MORRO RD
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-3927
Practice Address - Country:US
Practice Address - Phone:805-460-6333
Practice Address - Fax:805-468-4495
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA56175363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant