Clarence Ross Hilliard III, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY20666 Issued in CA

Practice address

8640 Trinidad Way
Roseville, CA 95747-8668

Phone

(916) 984-2131

Fax

(916) 676-8506

NPI assigned

Jun 2, 2006

Last updated

Sep 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rose-Marie Y. NietoGroup PAC ID 2163556531, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cameron Park Counseling Center, Inc.

  dba Cameron Park Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cameron Park, CA
  • NPI 1477760874
  Medicare reassignment Care Compare group
• Cameron Park Counseling Center

  • Point of Service
  • Cameron Park, CA
  • NPI 1093104325
  NPD (past)
• Hearthstone Counseling Services, Inc.

  • Clinical Psychologist
  • Roseville, CA
  • NPI 1891787644
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1508804808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 TRINIDAD WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957478668",
            "telephone_number": "916-984-2131",
            "fax_number": "916-676-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 TRINIDAD WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957478668",
            "telephone_number": "916-984-2131",
            "fax_number": "916-676-8506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3294 Royal Dr. Suite 13",
            "address_purpose": "LOCATION",
            "city": "Cameron Park",
            "state": "CA",
            "postal_code": "956828500",
            "country_code": "US",
            "telephone_number": "530-677-4404",
            "fax_number": "530-677-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILLIARD",
        "first_name": "CLARENCE",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY20666",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "address_1": "8640 Trinidad Way",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "957478668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard Hill, FNP
• Richard K Hill
• Robin M Hill, SOCIAL WORKER
• Taylor Dayne Hill, PA-C
• Dorothy Hilleary, LMFT
• Marti Louise Hills, PHARMD
• Juanita J Himenes
• Lawrence Joseph Hinahon
• Mujahid A Hines, MD
• Jeremy Thomas Hinton, DO

• Clinical Psychologist in Roseville, CA
• Providers in Roseville, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.