Provider Demographics
NPI:1609098698
Name:DIKES, VICKILYNNE (LM)
Entity Type:Individual
Prefix:
First Name:VICKILYNNE
Middle Name:
Last Name:DIKES
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 N INDIAN CANYON DR
Mailing Address - Street 2:SUITE W300
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4800
Mailing Address - Country:US
Mailing Address - Phone:760-416-3770
Mailing Address - Fax:760-320-8551
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:SUITE W300
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:760-416-3770
Practice Address - Fax:760-320-8551
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM47176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife