Provider Demographics
NPI:1497915953
Name:HILL, ERNESTINE LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:ERNESTINE
Middle Name:LYNN
Last Name:HILL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2043 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1253
Mailing Address - Country:US
Mailing Address - Phone:415-661-8787
Mailing Address - Fax:415-661-6708
Practice Address - Street 1:2043 19TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1253
Practice Address - Country:US
Practice Address - Phone:415-661-8787
Practice Address - Fax:415-661-6708
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT 5843225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant