Provider Demographics
NPI:1376706515
Name:DIAMOND, HILARY ANN
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:ANN
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5955 N ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-4280
Mailing Address - Country:US
Mailing Address - Phone:415-577-4797
Mailing Address - Fax:
Practice Address - Street 1:2220 MOUNTAIN BLVD
Practice Address - Street 2:STE 240
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2905
Practice Address - Country:US
Practice Address - Phone:510-822-6796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000000000000000OtherADULT EDUCATION CREDENTIAL