Individual
DR. HOLLY ANN HICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
11301 WILSHIRE BLVD, WEST LA VA HEALTH CARE CENTER, LOS ANGELES, CA 90073
(310) 478-3711
Mailing address
1830 TAFT AVE APT 101, LOS ANGELES, CA 90028-5741
(602) 579-1222
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT33909TLG
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/27/2017
Last updated
10/27/2021
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