Provider Demographics
NPI:1740006493
Name:HICKEY, OLIVIA JEANETTE (MSCN)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:JEANETTE
Last Name:HICKEY
Suffix:
Gender:F
Credentials:MSCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 S COURTRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-6379
Mailing Address - Country:US
Mailing Address - Phone:925-382-8662
Mailing Address - Fax:
Practice Address - Street 1:1961 S COURTRIGHT AVE
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-6379
Practice Address - Country:US
Practice Address - Phone:925-382-8662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education