Provider Demographics
NPI:1619257102
Name:WALSH, HILLARY D (MS COUNSELING)
Entity Type:Individual
Prefix:MS
First Name:HILLARY
Middle Name:D
Last Name:WALSH
Suffix:
Gender:F
Credentials:MS COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-4307
Mailing Address - Country:US
Mailing Address - Phone:650-638-0319
Mailing Address - Fax:
Practice Address - Street 1:1000 CAYUGA AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-3236
Practice Address - Country:US
Practice Address - Phone:415-469-4512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-28
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF67613106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist