Search › California › 1041C0700X
Tanner Hickman
NPI 1194272146 · on the registry since 2016
Practice
- Address
- 2495 W March Ln
Stockton, CA 95207 - Phone
- (209) 465-1080
- Organisation at this address
- Victor Community Support Services, Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 277
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 101YM0800X
104100000X - Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-08-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California