Active NPI
Evelyn Louise Hicks
- Behavior Technician
- Madera, CA
National Provider Identifier
1699236745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1915 Howard Rd Ste B&C
Madera, CA 93637-5163 - Phone
- (559) 330-2211
- Fax
- (559) 765-0075
- NPI assigned
- Mar 29, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1915 Howard Rd Ste B&C
Madera, CA 93637-5163
Mailing address
21800 Oxnard St Ste 1800
Woodland Hills, CA 91367-3633
Phone (818) 345-2345
Other practice location 1
1915 Howard Rd Ste B&c
Madera, CA 93637-5163
Phone (559) 330-2211 ext. 2550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93474242C77131 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | BehavioralTherapist | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553817600000",
"number": "1699236745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21800 OXNARD ST STE 1800",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913673633",
"telephone_number": "818-345-2345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 HOWARD RD STE B&C",
"city": "MADERA",
"state": "CA",
"postal_code": "936375163",
"telephone_number": "559-330-2211",
"fax_number": "559-765-0075"
}
],
"practiceLocations": [
{
"address_1": "1915 Howard Rd Ste B&c",
"address_purpose": "LOCATION",
"city": "Madera",
"state": "CA",
"postal_code": "936375163",
"country_code": "US",
"telephone_number": "559-330-2211 x2550",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HICKS",
"first_name": "EVELYN",
"middle_name": "LOUISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-29",
"last_updated": "2019-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "93474242C77131",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "BehavioralTherapist",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1915 Howard Rd Ste B&c",
"city": "Madera",
"state": "CA",
"country_code": "US",
"postal_code": "936375163",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.