Provider Demographics
NPI:1609807999
Name:HICKS, MARTA ANN
Entity Type:Individual
Prefix:MS
First Name:MARTA
Middle Name:ANN
Last Name:HICKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 SOLANO AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2118
Mailing Address - Country:US
Mailing Address - Phone:510-526-0434
Mailing Address - Fax:510-526-0492
Practice Address - Street 1:1660 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94707-2118
Practice Address - Country:US
Practice Address - Phone:510-526-0434
Practice Address - Fax:510-526-0492
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA001332237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist