1629240817 NPI number — DR. CARL FREDERICK HILKER III PSY.D.

Table of content: DR. CARL FREDERICK HILKER III PSY.D. (NPI 1629240817)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629240817 NPI number — DR. CARL FREDERICK HILKER III PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILKER
Provider First Name:
CARL
Provider Middle Name:
FREDERICK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
Provider Credential Text:
PSY.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629240817
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1150 VETERANS BLVD
Provider Second Line Business Mailing Address:
PSYCHIATRY DEPT
Provider Business Mailing Address City Name:
REDWOOD CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94063-2037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-299-4773
Provider Business Mailing Address Fax Number:
650-299-4335

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1150 VETERANS BLVD
Provider Second Line Business Practice Location Address:
PSYCHIATRY DEPT
Provider Business Practice Location Address City Name:
REDWOOD CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94063-2037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-299-4773
Provider Business Practice Location Address Fax Number:
650-299-4335
Provider Enumeration Date:
03/27/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC2200X , with the licence number:  PSY 21457 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)