Individual provider Active NPI

David B Hickel, PH.D.

  • Clinical Psychologist
  • Glendora, CA
National Provider Identifier
1629109079
Registry record updated Aug 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY13855 Issued in CA
Practice address
150 E Meda Ave Ste 110
Glendora, CA 91741-2607
Phone
(626) 272-9575
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY13855 CA Primary

Addresses

Primary practice location

150 E Meda Ave Ste 110
Glendora, CA 91741-2607

Mailing address

150 E Meda Ave Ste 110
Glendora, CA 91741-2607
Phone (626) 272-9575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20221012001474 CO Practitioner - Clinical Psychologist 7012383375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

10120 Twenty Mile Rd
Parker, CO 80134-5666
Phone (719) 540-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY13855CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC Clinical CurrentSince Sep 29, 2022 Accepting new patients
Family Care Center, LLC CurrentSince Sep 29, 2022 Accepting new patients

Locations

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

10120 Twenty Mile Rd
Parker, CO 80134
Phone (303) 228-8871

10120 Twenty Mile Rd
Ste 100
Parker, CO 80134
Phone (303) 228-8871

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344124800000",
    "number": "1629109079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E MEDA AVE STE 110",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412607",
            "telephone_number": "626-272-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E MEDA AVE STE 110",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412607",
            "telephone_number": "626-272-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEL",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2012-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.