Doctor Name: | DR. JASON HILBERG |
NPI Number: | 1053737361 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D |
License Number: | 16579 |
Business Practice Address: | 855 Oak Grove Ave Suite 201 Menlo Park, CA - 940254440 |
Business Phone Number: | 6502899078 |
Business Fax Number: | 6503223716 |
Mailing Address: | 855 Oak Grove Ave, Suite 201 MENLO PARK |
State: | CA |
Postal Code: | 940254440 |
Phone Number: | 6502899078 |
Fax Number: | 6503223716 |
NPI Enumeration Date: | 03/11/2014 |
NPI Last Update Date: | 03/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | 16579 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |