Provider Demographics
NPI:1164777371
Name:HIRANO, HILLEVI (RPT)
Entity Type:Individual
Prefix:
First Name:HILLEVI
Middle Name:
Last Name:HIRANO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 SOQUEL AVE
Mailing Address - Street 2:103
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2097
Mailing Address - Country:US
Mailing Address - Phone:831-464-8200
Mailing Address - Fax:831-477-2924
Practice Address - Street 1:9000 SOQUEL AVE
Practice Address - Street 2:103
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2097
Practice Address - Country:US
Practice Address - Phone:831-464-8200
Practice Address - Fax:831-477-2924
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22658225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist