Active NPI
Steven Douglas Hickman, PSY.D.
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1003873175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY16677
- Practice address
- 200 West Arbor Drive
Mc8218
San Diego, CA 92103-8218 - Phone
- (619) 543-6470
- Fax
- (619) 543-3738
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY16677 | CA | Primary |
Addresses
Primary practice location
200 West Arbor Drive
Mc8218
San Diego, CA 92103-8218
Mailing address
200 West Arbor Drive
Mc8218
San Diego, CA 92103-8218
Phone (619) 543-6470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY166770 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16677 | CA | MD | Clinical Psychologist |
| 16677 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003873175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 WEST ARBOR DRIVE",
"address_2": "MC8218",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921038218",
"telephone_number": "619-543-6470",
"fax_number": "619-543-3738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 WEST ARBOR DRIVE",
"address_2": "MC8218",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921038218",
"telephone_number": "619-543-6470",
"fax_number": "619-543-3738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "STEVEN",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY16677",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY166770",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.