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JACK R HILLS PSYD
NPI 1265803696
Psychologist - Clinical in Los Altos, CA

Active since October 12, 2015
167 S SAN ANTONIO RD STE 2, LOS ALTOS, CA 94022(650) 422-7475 Get Directions Write a Review

NPPES record last updated: July 15, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 15, 2026, Nov 18, 2025 (2 updates tracked since 2025).

About Jack R Hills Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK R HILLS PSYD (NPI 1265803696) is an individual clinical provider in Los Altos, California, licensed in California (36182) and active in the NPI registry since October 2015. He maintains 2 additional practice locations and is a graduate of Other (2023).

NPPES Registry Identity

NPI1265803696
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameJACK R HILLSCredential: PSYD
Location Address167 S SAN ANTONIO RD STE 2Los Altos, CA 94022-3055
Mailing Address100 1/2 E Haley St Apt BSanta Barbara, CA 93101-5302
Phone(650) 422-7475
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateOctober 12, 2015
Last NPPES UpdateJuly 15, 20262 updates tracked since enumeration
NPPES CertifiedJuly 15, 2026
✔ NPI 1265803696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · 36182
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
167 S SAN ANTONIO RD STE 2, Los Altos, CA 94022
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11900 OFarrell St Ste 250San Mateo, CA 94403-1387 · Phone (310) 601-5099
Location 211620 Wilshire Blvd Ste 520Los Angeles, CA 90025-1778 · Phone (310) 601-5099 · Fax (888) 988-1786

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack R Hills Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7315422714
PECOS Enrollment IDI20260403000091

Medicare Billing Reassignment

Medicare enrollment records show Jack Hills reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Amae Health Medical Associates, PC
308 mi
Adult Mental Health
11620 WILSHIRE BLVD STE 520
Los Angeles, CA 90025
  • Reassigned Medicare billing, California enrollment
  • 13 clinicians in this Medicare group
NPI 1346958295 (424) 293-0031

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KEITH M SAKATA MD
Psychiatry & Neurology (Psychiatry)
167 S SAN ANTONIO RD STE 2
LOS ALTOS, CA 94022
Santa Clara County (310) 601-5099
MRS. KAITLYN CHRISTINE-POWERS CUADERNO
Social Worker (Clinical)
167 S SAN ANTONIO RD STE 2
LOS ALTOS, CA 94022
Santa Clara County (650) 946-1200
JULIE ADKINS
Dietitian, Registered
167 S SAN ANTONIO RD STE 2
LOS ALTOS, CA 94022
Santa Clara County (650) 946-1200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Hills's NPI number?

The NPI number for Jack Hills is 1265803696. It was assigned to this individual provider in the NPPES registry on October 12, 2015.

Where is Jack Hills located?

Jack Hills practices at 167 S San Antonio Rd Ste 2, Los Altos, CA 94022. The listed phone number is (650) 422-7475.

What is Jack Hills's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jack Hills enrolled in Medicare?

Yes. Jack Hills is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jack Hills's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jack Hills reassigns Medicare benefits to Amae Health Medical Associates, PC (Los Angeles, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Hills's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jack Hills was last updated on July 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.