Provider Demographics
NPI:1598778268
Name:HILARIO, ROSA O (AUD)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:O
Last Name:HILARIO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-0568
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-1727
Practice Address - Country:US
Practice Address - Phone:909-623-2272
Practice Address - Fax:909-397-9248
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 2917237600000X
CAAUD 287231H00000X
CASP 5897235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAUD287Medicare ID - Type UnspecifiedAUDIOLOGY
CAR13973Medicare UPIN