Provider Demographics
NPI:1063768794
Name:SHIMIZU, HILDA (BS)
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:
Last Name:SHIMIZU
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S MAIN ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4513
Mailing Address - Country:US
Mailing Address - Phone:714-543-4333
Mailing Address - Fax:714-543-9843
Practice Address - Street 1:500 S MAIN ST STE 1100
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4513
Practice Address - Country:US
Practice Address - Phone:714-543-4333
Practice Address - Fax:714-543-9843
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator