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Maria D. Hicks

Marriage & Family Therapist

Behavioral Health & Social Service Providers

7474 El Cajon Blvd, La Mesa, CA 91942-1311

PECOS Enrollment

Based on the most recent information from CMS, provider Maria D. Hicks does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1285122549
Provider Type
Individual
Full Name
Hicks, Maria D.
Gender
Female

Sole Proprietor
No
Enumeration Date
4/23/2018
Last Updated
1/20/2021

Contact Information

Practice Location

7474 El Cajon Blvd, La Mesa, CA 91942-1311

(858) 848-9362

Unlisted Fax

Mailing Location

7474 El Cajon Blvd, La Mesa, CA 91942-1311

(858) 848-9362

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 106842 California
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License 106842 California
Code 171M00000X	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer

Maria D. Hicks

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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Ippolito, Stacy

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Hu, Jingqi