SHERONDA LATRECIA HICKS (NPI# 1053807602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053807602 |
| Entity Type | Individual |
| Full Name | SHERONDA LATRECIA HICKS |
| Credential | ACNP-C |
| Practice Address |
100 S Harding Blvd Ste 2 Roseville CA 95678-3360 |
| Practice Telephone | 9167973999 |
| Mailing Telephone | 9167973999 |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2019-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
95010260 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NONE | 1053807602 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2612 Stonehaven Dr, Sacramento, CA 958271131 | 4783359645 |
| Street Address |
100 S HARDING BLVD STE 2 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95678-3360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1396378980 | David F Shirley M D P C | Family Medicine | 4001 Impala Circle, Roseville, CA 95678 | 2020-02-21 |
| 1083256051 | Rosemary Ellen Robben | Community Health Worker | Cirby Wellness Center 101 Cirby Hills Drive, Roseville, CA 95678 | 2019-10-11 |
| 1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
| 1174093793 | Neftali Hernandez | Behavior Technician | 1100 Roseville Parkway Apt 1021, Roseville, CA 95678 | 2018-11-26 |
| 1467951798 | Amarantha Martinez | Behavior Technician | 1900 Quail Ridge Road, #99, Roseville, CA 95678 | 2018-02-01 |
| 1093231276 | Compassionate Home Health, Ltd | Home Health | 1100 Melody Lane, Suite 106, Roseville, CA 95678 | 2017-08-18 |
| 1629598891 | Jimena Andrade Martins | Behavior Technician | 602 Atkinson Street, Roseville, CA 95678 | 2017-06-20 |
| 1891221057 | Zride Inc | Taxi | 106 Church Street, Suite 2, Roseville, CA 95678 | 2017-05-10 |
| 1568997641 | Joline Trinh | Pharmacist | 1030 Pleasant Grove Boulevard, Roseville, CA 95678 | 2017-04-26 |
| Find all providers in zip 95678 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134757263 | Cheri Angela White | Nurse Practitioner | 1 Medical Plaza Dr Ofc, Roseville, CA 95661-3037 | 2020-04-01 |
| 1215407051 | Clifford Leo Faubert | Nurse Practitioner | 1937 Ellesmere Loop, Roseville, CA 95747 | 2018-12-04 |
| 1700423936 | Marissa Bauer | Nurse Practitioner | 2140 Professional Dr Ste 210, Roseville, CA 95661-3776 | 2019-12-06 |
| 1245325315 | Sharon Anne Hapak | Nurse Practitioner | 1600 Eureka Rd, Muskuloskleletal Services, Roseville, CA 95661-3027 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619442 | Dolores Josephine Meehan | Nurse Practitioner | South Bay Vascular Center, 2255 South Bascom Avenue Suite 200, Campbell, CA 95008-7800 | 2020-11-03 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1851990550 | Fernanda Monteon Ibarra | Nurse Practitioner | 30222 Belmont Ct, Agoura Hills, CA 91301-4611 | 2020-10-22 |
| 1780283168 | Brenda Rienru Rhima | Nurse Practitioner | 24657 Rockston Dr, Corona, CA 92883-1614 | 2020-10-18 |
| 1215535034 | Shiji John | Nurse Practitioner | 3765 Gunnison Cir, Corona, CA 92881-8486 | 2020-10-14 |
| 1053919258 | Lacey Etienne Neufeld | Nurse Practitioner | Marshall Transitional Care Unit, 1100 Marshall Way, Placerville, CA 95667 | 2020-10-12 |
| 1063028298 | Kanokwan Kultan | Nurse Practitioner | 15850 Babcock St, San Diego, CA 92127-3680 | 2020-09-22 |
| 1538775093 | David Lee | Nurse Practitioner | 5710 S Glennie Ln Apt A, Los Angeles, CA 90016-1063 | 2020-09-21 |
| 1124634886 | Catherine Kestenian | Nurse Practitioner | 351 E Foothill Blvd Ste 250, Arcadia, CA 91006-7426 | 2020-09-18 |
| 1285249565 | Anu Tharoor | Nurse Practitioner | 505 Parnassus Ave Fl 9, San Francisco, CA 94143-2204 | 2020-09-13 |
| Find all providers with the same taxonomy | ||||
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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.