Provider Demographics
NPI:1578020293
Name:HILL, ALEXANDER CHARLES
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:CHARLES
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 CORDELIA CIR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-5664
Mailing Address - Country:US
Mailing Address - Phone:707-761-7963
Mailing Address - Fax:
Practice Address - Street 1:161 BUTCHER RD
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-5685
Practice Address - Country:US
Practice Address - Phone:707-305-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician