Provider Demographics
NPI:1881254779
Name:HILL, DIANNA RENEE' I (LCASW)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:RENEE'
Last Name:HILL
Suffix:I
Gender:F
Credentials:LCASW
Other - Prefix:
Other - First Name:DIANNA
Other - Middle Name:RENEE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1065 A ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4122
Mailing Address - Country:US
Mailing Address - Phone:510-657-7293
Mailing Address - Fax:510-657-7293
Practice Address - Street 1:1065 A ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4122
Practice Address - Country:US
Practice Address - Phone:510-938-1747
Practice Address - Fax:510-720-9352
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA137308390200000X, 1041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical