Individual provider Active NPI

Mackenzie Rose Hichman, AU.D.

  • Audiologist
  • Oakland, CA
National Provider Identifier
1073480554
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
4111 Issued in CA
Practice address
3751 Broadway Ste B
Oakland, CA 94611-5613
Phone
(510) 752-8330
NPI assigned
Oct 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 4111 CA Primary

Addresses

Primary practice location

3751 Broadway Ste B
Oakland, CA 94611-5613

Mailing address

1044 Judah St Apt 5
San Francisco, CA 94122-2052
Phone (714) 673-2623

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1073480554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 JUDAH ST APT 5",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941222052",
            "telephone_number": "714-673-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 BROADWAY STE B",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115613",
            "telephone_number": "510-752-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICHMAN",
        "first_name": "MACKENZIE",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "4111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.