Provider Demographics
NPI:1912615808
Name:HILLHOUSE, KERRIE LYNNE
Entity Type:Individual
Prefix:
First Name:KERRIE
Middle Name:LYNNE
Last Name:HILLHOUSE
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 1:8582 PYLE WAY
Mailing Address - Street 2:
Mailing Address - City:MIDWAY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92655-1142
Mailing Address - Country:US
Mailing Address - Phone:714-230-5212
Mailing Address - Fax:
Practice Address - Street 1:2201 E 4TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3804
Practice Address - Country:US
Practice Address - Phone:714-230-5212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician