Provider Demographics
NPI:1669662045
Name:HILL, JAMES W (CADCII, NCAC I, CCPS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:W
Last Name:HILL
Suffix:
Gender:M
Credentials:CADCII, NCAC I, CCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2085 RUSTIN AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-2498
Mailing Address - Country:US
Mailing Address - Phone:951-955-1745
Mailing Address - Fax:951-955-7220
Practice Address - Street 1:2085 RUSTIN AVE FL 1
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-2498
Practice Address - Country:US
Practice Address - Phone:951-955-1745
Practice Address - Fax:951-955-7220
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAII5411214101YA0400X
CACPS0281116405300000X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No405300000XOther Service ProvidersPrevention Professional
No175T00000XOther Service ProvidersPeer Specialist