EDWARD HICKERSON (NPI# 1073903159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073903159 |
| Entity Type | Individual |
| Full Name | EDWARD HICKERSON |
| Practice Address |
3360 N Highway 59 Ste K Merced CA 95348-9405 |
| Practice Telephone | 2097263090 |
| Mailing Telephone | 2097263090 |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2019-11-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
3360 N HIGHWAY 59 STE K |
| City | MERCED |
| State | CA |
| Zip Code | 95348-9405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871895607 | Rebecca Lynn Mcmullen | Counselor | 3360 N Highway 59 Ste K, Merced, CA 95348-9405 | 2010-11-30 |
| 1376152751 | La Quita D Richardson | Case Manager/Care Coordinator | 3360 N Highway 59 Ste K, Merced, CA 95348-9405 | 2020-07-30 |
| 1841836426 | Gorge Carlo Vizcarra Granados | Case Manager/Care Coordinator | 3360 N Highway 59 Ste K, Merced, CA 95348-9405 | 2019-11-19 |
| 1134763089 | Sandie Sevilla | Acupuncturist | 3360 N Highway 59 Ste K, Merced, CA 95348-9405 | 2019-11-04 |
| 1164064838 | Ivania Aleman | Counselor | 3360 N Highway 59 Ste K, Merced, CA 95348-9405 | 2019-10-14 |
| 1538718259 | Toren Saetern | Case Manager/Care Coordinator | 3360 N Highway 59 Ste K, Merced, CA 95348-9405 | 2019-09-05 |
| 1548817927 | Liliana Casillas | Counselor | 3360 N Highway 59 Ste K, Merced, CA 95348-9405 | 2019-08-21 |
| 1699321257 | Maricruz Valencia | Case Manager/Care Coordinator | 3360 N Highway 59 Ste K, Merced, CA 95348-9405 | 2019-08-09 |
| 1174187025 | Laura Angelica Lopez-mora | Case Manager/Care Coordinator | 3360 N Highway 59 Ste K, Merced, CA 95348-9405 | 2019-04-25 |
| 1396202149 | Tawnya Jean Severe | Social Worker | 3360 N Highway 59 Ste K, Merced, CA 95348-9405 | 2019-02-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063031649 | Sydney Towle | Counselor | 3360 N Hwy 59 Suite K, Merced, CA 95348 | 2020-04-13 |
| 1972147544 | Aaliyah Belt | Behavior Technician | 2808 Park Ave, Suite A, Merced, CA 95348 | 2019-11-06 |
| 1922566025 | Michelle Chao Lee | Case Manager/Care Coordinator | 3360 North Hwy 59 Suite K, Merced, CA 95348 | 2019-03-07 |
| 1760952246 | Noemi Diaz | Counselor | 3360 North Hwy.59 Suite K, Merced, CA 95348 | 2018-11-28 |
| 1518451632 | Kenneth Tiea Pay | Pharmacist | 767 Ironstone Dr, Merced, CA 95348 | 2018-06-21 |
| 1295223444 | Andraya Diane Plascencia | Behavior Technician | 335 M St, Merced, CA 95348 | 2018-04-24 |
| 1801398839 | Elisabet Pulido | Case Manager/Care Coordinator | 3360 N State Hwy 59, K, Merced, CA 95348 | 2018-03-06 |
| 1184126674 | Carolina Rosales | Behavior Technician | 3335 M St., Merced, CA 95348 | 2018-03-01 |
| 1659897957 | Melody Vega | Social Worker | 3195 M Street, Merced, CA 95348 | 2017-08-17 |
| 1942739305 | Salvador Tinoco Jaramillo | Marriage & Family Therapist | 3360 N Highway 59 Suite K, Merced, CA 95348 | 2017-06-08 |
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| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942520 | Samantha Canal | Counselor | 300 E 13th St Suite C, Merced, CA 95341 | 2020-08-11 |
| 1760032312 | Mary Jo Diaz | Counselor | 1022 W 18th St, Merced, CA 95340-4505 | 2019-09-16 |
| 1760952246 | Noemi Diaz | Counselor | 3360 North Hwy.59 Suite K, Merced, CA 95348 | 2018-11-28 |
| 1164868683 | Maria Lopez | Counselor | 1172 D St Apt B, Merced, CA 95341-6377 | 2013-05-13 |
| 1285971572 | Pangdao Thao | Counselor | 940 Olivewood Dr Apt 2, Merced, CA 95348-1223 | 2013-01-07 |
| 1073858775 | Jessica Lindsey Kirby | Counselor | 3360 N. Hwy 59, Suite K, Merced, CA 95348 | 2012-12-06 |
| 1336374206 | Diana Marie Galvan Elgammal | Counselor | 642 W. Main St., Merced, CA 95340 | 2009-05-21 |
| 1902022239 | Maria Socorro Reyes-alfaro | Counselor | 2115 W. Wardrobe, Merced, CA 95340 | 2007-04-17 |
| 1205959681 | Rachel Trevino | Counselor | 2292 Beachwood Dr, Merced, CA 95348-3721 | 2007-04-09 |
| 1730229733 | Connie Theresa Garcia | Counselor | 480 East 13th Street, Merced, CA 95341-4600 | 2007-02-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.