Azita Melody Hickey, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY30683 Issued in CA

Practice address

9921 Carmel Mountain Rd Ste 204
San Diego, CA 92129-2813

Phone

(909) 957-0556

NPI assigned

May 23, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Azita Hickey PH D PsychologistGroup PAC ID 8729317078, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Azita Hickey PH D Psychologist

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1770049959
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1548520554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9921 CARMEL MOUNTAIN RD STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292813",
            "telephone_number": "909-957-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9921 CARMEL MOUNTAIN RD STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292813",
            "telephone_number": "909-957-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "AZITA",
        "middle_name": "MELODY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Michelle Hibshman
• Carrie Hicinbothom, BCBA
• Samantha Hicke
• Britney Nicole Hickerson
• Ashley Krystine Hickey
• Brianna Hickey
• Crista Hickey, FNP-C
• Jessica Ellen Hickey, ND
• Lindsey Hickey
• Rachel Rene Hickey, AMFT

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.