Demetrius Antonyo Contellis Hicks II

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF98596 Issued in CA

Practice address

1461 E Cooley Dr Ste 100
Colton, CA 92324-3921

Phone

(909) 320-0064

NPI assigned

Jul 31, 2015

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1669858684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24275 JEFFERSON AVE",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925627285",
            "telephone_number": "951-677-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 E COOLEY DR STE 100",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243921",
            "telephone_number": "909-320-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "DEMETRIUS",
        "middle_name": "ANTONYO CONTELLIS",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-31",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF98596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trescina Michelle Hernandez
• Amber Nicole Herrera
• Andrew Warren Hesseltine, MD
• Mary M Heyl, RN PNP
• Hi-Top Hospice Care Inc.
• Lisa Higgins
• Charles Anthony Hille, MA.,MS
• Donald Everett Hills, P.A.-C
• Gabriel Hintzsche, D.O.
• Daniel Hioe

• All providers in Colton, CA
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.