Provider Demographics
NPI:1750167995
Name:HILL, KIMBERLY MICHELLE
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:MICHELLE
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 1:4928 E CLINTON WAY STE 108
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1526
Mailing Address - Country:US
Mailing Address - Phone:757-952-5081
Mailing Address - Fax:213-805-8595
Practice Address - Street 1:1105 E YALE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-6238
Practice Address - Country:US
Practice Address - Phone:559-252-6844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator