Individual
ELENA MIREYA HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
902 S MYRTLE AVE, MONROVIA, CA 91016-3427
(626) 357-3258
Mailing address
257 S DE LACEY AVE UNIT 1129, PASADENA, CA 91105-4188
(818) 476-6186
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95010134
CA
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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