Provider Demographics
NPI:1366624926
Name:HILL, TOBY SHOTWELL (HIS)
Entity Type:Individual
Prefix:
First Name:TOBY
Middle Name:SHOTWELL
Last Name:HILL
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1196 BOULEVARD WAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-1193
Mailing Address - Country:US
Mailing Address - Phone:925-658-1290
Mailing Address - Fax:925-884-8013
Practice Address - Street 1:1196 BOULEVARD WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-1193
Practice Address - Country:US
Practice Address - Phone:925-658-1290
Practice Address - Fax:925-884-8013
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 7306237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist