Elena Mireya Hicks, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95010134 Issued in CA

Practice address

902 S Myrtle Ave
Monrovia, CA 91016-3427

Phone

(626) 357-3258

NPI assigned

Jan 29, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Luis Alesandro Larrazabal Martinez MD PC

  dba Clarity Pediatrics Medical Group

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1649910589
  NPD (past)

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1619431269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 S DE LACEY AVE UNIT 1129",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911054188",
            "telephone_number": "818-476-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S MYRTLE AVE",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163427",
            "telephone_number": "626-357-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "ELENA",
        "middle_name": "MIREYA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95010134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lasandra Hickman-Lewis
• McKenna Hickman
• Anthony Hicks
• Breyonna Hicks
• Bria Hicks
• Jakara Hicks
• Zenora Hicks
• Shelby Hickson
• Madelen Hidalgo
• Dominique Higashi

• Psychiatric/Mental Health Nurse Practitioner in Monrovia, CA
• Providers in Monrovia, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.