Provider Demographics
NPI:1982025755
Name:GREENE, HILLEL (ASW)
Entity Type:Individual
Prefix:
First Name:HILLEL
Middle Name:
Last Name:GREENE
Suffix:
Gender:M
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8464
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-8464
Mailing Address - Country:US
Mailing Address - Phone:646-319-2820
Mailing Address - Fax:
Practice Address - Street 1:SAN QUENTIN STATE PRISON
Practice Address - Street 2:CENTRAL HEALTH SERVICES BUILDING 4TH FLOOR
Practice Address - City:SAN QUENTIN
Practice Address - State:CA
Practice Address - Zip Code:94964
Practice Address - Country:US
Practice Address - Phone:415-454-1460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-22
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60108104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker