Hicks, Devon M

Hicks, Devon M is an individual health care provider with primary practice located at 423 Mackay Dr , San Bernardino CA 92408-3230. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Nursing Service Providers / Licensed Practical Nurse. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Hicks, Devon M can be contacted via phone (909) 383-1073.

Contact Information

Primary practice address
423 Mackay Dr San Bernardino CA 92408-3230
Phone: (909) 383-1073
Fax: (909) 383-1456
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X RW0767 California
Nursing Service Providers / Licensed Practical Nurse 164W00000X VN246830 California

Profile Details

NPI number 1700097516
LBN Legal business name Hicks, Devon M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2007
Last updated Jun 29th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700097516 NPPES
California Other 5155 SIMON STAFF NUMBER

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