Provider Demographics
NPI:1053453597
Name:HILLBLOM, KATHERINE LOUISE (PHARMD , BCACP)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:LOUISE
Last Name:HILLBLOM
Suffix:
Gender:F
Credentials:PHARMD , BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8168 POLO CROSSE AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95829-6545
Mailing Address - Country:US
Mailing Address - Phone:916-689-6034
Mailing Address - Fax:
Practice Address - Street 1:3240 ARDEN WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2015
Practice Address - Country:US
Practice Address - Phone:916-486-5256
Practice Address - Fax:916-486-5175
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV07046183500000X
CARPH 30912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist