Individual provider Active NPI

Patricia Grace Hickey, MSW, LCSW

  • Clinical Social Worker
  • Lodi, CA
National Provider Identifier
1720418502
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW71406 Issued in CA
Practice address
330 S Fairmont Ave Ste 7
Lodi, CA 95240-3843
Phone
(916) 926-2372
NPI assigned
Nov 15, 2013
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW71406 CA Primary

Addresses

Primary practice location

330 S Fairmont Ave Ste 7
Lodi, CA 95240-3843

Mailing address

P.O. Box 521
Woodbridge, CA 95258

Other practice location 1

6707 Embarcadero Dr
Stockton, CA 95219-3382
Phone (209) 956-4240

Other practice location 2

1300 W Lodi Ave
Lodi, CA 95242-3000
Phone (209) 334-2126

Other names 1

  • Patricia Grace Hoffman Former name

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

State licenses

LicenseStateTypeSpecialty
LCSW71406CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720418502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 521",
            "city": "WOODBRIDGE",
            "state": "CA",
            "postal_code": "95258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S FAIRMONT AVE STE 7",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403843",
            "telephone_number": "916-926-2372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6707 Embarcadero Dr",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952193382",
            "country_code": "US",
            "telephone_number": "209-956-4240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 W Lodi Ave",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "952423000",
            "country_code": "US",
            "telephone_number": "209-334-2126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "PATRICIA",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW71406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "HOFFMAN",
            "middle_name": "GRACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.