Individual provider Active NPI

Beverly Hickman, PHARM D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Rancho Cordova, CA
National Provider Identifier
1972921013
Registry record updated Apr 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
RPH 41983 Issued in CA
Practice address
3400 Data Dr
Rancho Cordova, CA 95670-7956
Phone
(916) 952-8008
NPI assigned
Apr 5, 2014
Last updated
Apr 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH 41983 CA Primary

Addresses

Primary practice location

3400 Data Dr
Rancho Cordova, CA 95670-7956

Mailing address

705 Spumante CT
El Dorado Hills, CA 95762-3962
Phone (916) 939-1835

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH 41983CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1396656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396656000000",
    "number": "1972921013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 SPUMANTE CT",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957623962",
            "telephone_number": "916-939-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956",
            "telephone_number": "916-952-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "BEVERLY",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-05",
        "last_updated": "2014-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "RPH 41983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2014; 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.