Provider Demographics
NPI:1831378157
Name:HILEN, PETER EMERSON (MFT)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:EMERSON
Last Name:HILEN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WHITE PELICAN LN
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1225
Mailing Address - Country:US
Mailing Address - Phone:949-429-9398
Mailing Address - Fax:
Practice Address - Street 1:17461 IRVINE BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3034
Practice Address - Country:US
Practice Address - Phone:949-429-9398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-02
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47494106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist