Provider Demographics
NPI:1922305804
Name:CISCO REUTER, HILARY (PHD)
Entity Type:Individual
Prefix:DR
First Name:HILARY
Middle Name:
Last Name:CISCO REUTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CHARLEMONT DR
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-5216
Mailing Address - Country:US
Mailing Address - Phone:949-243-2807
Mailing Address - Fax:949-487-5242
Practice Address - Street 1:31831 CAMINO CAPISTRANO STE 100
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3220
Practice Address - Country:US
Practice Address - Phone:949-487-5251
Practice Address - Fax:949-487-5242
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23620103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical