Provider Demographics
NPI:1669883070
Name:HILL, LATISHA JEWELL (LMFT, PPSC)
Entity type:Individual
Prefix:
First Name:LATISHA
Middle Name:JEWELL
Last Name:HILL
Suffix:
Gender:F
Credentials:LMFT, PPSC
Other - Prefix:
Other - First Name:LATISHA
Other - Middle Name:HILL
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT, PPSC
Mailing Address - Street 1:864 GRAND AVE # 935
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3906
Mailing Address - Country:US
Mailing Address - Phone:619-844-1345
Mailing Address - Fax:619-354-7193
Practice Address - Street 1:1455 FRAZEE RD
Practice Address - Street 2:SUITE 500
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-844-1345
Practice Address - Fax:619-354-7193
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA180150741101YS0200X
TX204098106H00000X
CA105316106H00000X
CA76807106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool