Provider Demographics
NPI:1417596289
Name:SCOTT-HICKMAN, LINDA ANN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ANN
Last Name:SCOTT-HICKMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ANN
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:2474 MCLOUD AVE
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5220
Mailing Address - Country:US
Mailing Address - Phone:510-710-2661
Mailing Address - Fax:510-727-3326
Practice Address - Street 1:20103 LAKE CHABOT RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5305
Practice Address - Country:US
Practice Address - Phone:510-727-2740
Practice Address - Fax:510-727-3326
Is Sole Proprietor?:No
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist