Provider Demographics
NPI:1811908585
Name:HIXON, DONALD W (RN)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:W
Last Name:HIXON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 BON AIR RD
Mailing Address - Street 2:CMHS
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-1702
Mailing Address - Country:US
Mailing Address - Phone:415-499-3096
Mailing Address - Fax:415-499-6313
Practice Address - Street 1:250 BON AIR RD
Practice Address - Street 2:CMHS
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-1702
Practice Address - Country:US
Practice Address - Phone:415-499-3096
Practice Address - Fax:415-499-6313
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN336230163WA2000X
CA336230163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator