Provider Demographics
NPI:1760914790
Name:HELEN HILLIX-DI SANTO, MARRIAGE AND FAMILY THERAPI
Entity Type:Organization
Organization Name:HELEN HILLIX-DI SANTO, MARRIAGE AND FAMILY THERAPI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HILLIX-DI SANTO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:760-990-9053
Mailing Address - Street 1:3814 LAKE CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-7872
Mailing Address - Country:US
Mailing Address - Phone:760-990-9053
Mailing Address - Fax:760-645-3975
Practice Address - Street 1:3814 LAKE CIRCLE DR
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-7872
Practice Address - Country:US
Practice Address - Phone:760-990-9053
Practice Address - Fax:760-645-3975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMFC20114106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty