Provider Demographics
NPI:1659449726
Name:HILLEY, LISA SUZANNE (PHD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:SUZANNE
Last Name:HILLEY
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 HOWARD ST RM 524
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2638
Mailing Address - Country:US
Mailing Address - Phone:415-672-5686
Mailing Address - Fax:
Practice Address - Street 1:1380 HOWARD ST RM 524
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2638
Practice Address - Country:US
Practice Address - Phone:415-672-5686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20617103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist