Active NPI
Wendy Ann Staples Hicks, D.C.
- Chiropractor
- Petaluma, CA
National Provider Identifier
1568873040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 32939
- Practice address
- 1445 Technology LN
Ste A3
Petaluma, CA 94954-7613 - Phone
- (707) 782-9303
- NPI assigned
- May 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 32939 | CA | Primary |
Addresses
Primary practice location
1445 Technology LN
Ste A3
Petaluma, CA 94954-7613
Mailing address
1445 Technology LN
Ste A3
Petaluma, CA 94954-7613
Phone (707) 285-7092
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140725001925 | CA | Practitioner - Chiropractic | 0042436156 | Practice locations: Petaluma, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569542400000",
"number": "1568873040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1445 TECHNOLOGY LN",
"address_2": "STE A3",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949547613",
"telephone_number": "707-285-7092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1445 TECHNOLOGY LN",
"address_2": "STE A3",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949547613",
"telephone_number": "707-782-9303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "WENDY",
"middle_name": "ANN STAPLES",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-18",
"last_updated": "2019-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "32939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.