Provider Demographics
NPI:1770636318
Name:HILL, ANGELINA FIDEL (RN NP PHN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELINA
Middle Name:FIDEL
Last Name:HILL
Suffix:
Gender:F
Credentials:RN NP PHN
Other - Prefix:MRS
Other - First Name:ANGIE
Other - Middle Name:FIDEL
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN NP PHN
Mailing Address - Street 1:275 BECK AVE # MS -240
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6804
Mailing Address - Country:US
Mailing Address - Phone:707-784-8070
Mailing Address - Fax:707-438-2500
Practice Address - Street 1:275 BECK AVE # MSC -240
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6804
Practice Address - Country:US
Practice Address - Phone:707-784-8070
Practice Address - Fax:707-438-2500
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275757163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health