Provider Demographics
NPI:1356544084
Name:HILL, SHAVON MARIE
Entity type:Individual
Prefix:
First Name:SHAVON
Middle Name:MARIE
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 E FLAMINGO RD STE C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5270
Mailing Address - Country:US
Mailing Address - Phone:323-921-7570
Mailing Address - Fax:
Practice Address - Street 1:6630 S VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047-1650
Practice Address - Country:US
Practice Address - Phone:323-565-2043
Practice Address - Fax:323-565-2044
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376J00000XNursing Service Related ProvidersHomemaker