Provider Demographics
NPI:1689855090
Name:HILLIS, VIERA (RN)
Entity Type:Individual
Prefix:
First Name:VIERA
Middle Name:
Last Name:HILLIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-2316
Mailing Address - Country:US
Mailing Address - Phone:714-834-7763
Mailing Address - Fax:
Practice Address - Street 1:1540 E 1ST ST
Practice Address - Street 2:STE. 100
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-6341
Practice Address - Country:US
Practice Address - Phone:714-972-3740
Practice Address - Fax:714-972-3744
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA280811163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health