Jabbar Hicklin, PHD.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY23521 Issued in CA

Practice address

12450 Van Nuys Blvd
Suite 200
Pacoima, CA 91331-1391

Phone

(818) 896-1161

Fax

(818) 896-5069

NPI assigned

Sep 15, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pure Autism Counseling Center IncGroup PAC ID 4284967167, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19641/brand/1/csg/1/fhir/r4

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.

• Pure Autism Counseling Center Inc

  • Community/Behavioral Health Agency
  • Santa Clarita, CA
  • NPI 1649737735
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1598166126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12450 VAN NUYS BLVD",
            "address_2": "SUITE 200",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913311391",
            "telephone_number": "818-896-1161",
            "fax_number": "818-896-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 VAN NUYS BLVD",
            "address_2": "SUITE 200",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913311391",
            "telephone_number": "818-896-1161",
            "fax_number": "818-896-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLIN",
        "first_name": "JABBAR",
        "credential": "PHD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-15",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6758",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7420",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7068",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Starlene Hernandez
• Yansi Elizabeth Hernandez
• Yasmen Hernandez
• Carolina Herrera, RDN
• Brandi Noel Hersh
• Erika Joyce Hilario
• Hillview Mental Health Center, Inc.
• Hillview Mental Health Center, Inc.
• Hillview Mental Health Center, Inc.
• Hillview Mental Health Center, Inc.

• Clinical Psychologist in Pacoima, CA
• Providers in Pacoima, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.