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General NPI Number Information
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NPI Number | 1164810131
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Entity Type | Individual
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Provider Name | CHERYL JULIE HICKEY MPT, MS, EDD
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Gender | Female
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Dates
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Enumeration Date | 12/29/2014
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Last Update Date | 12/29/2014
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Provider Practice Location Address
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Address Line | 7265 N 1ST ST #105
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City | FRESNO
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State | CA
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Zip | 93720-2956
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Country | US
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Telephone | 559-431-8181
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Fax |
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Provider Business Mailing Address
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Address Line | 2345 E SAN RAMON AVE MS MH 29
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City | FRESNO
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State | CA
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Zip | 93740-8031
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Country | US
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Telephone | 559-278-3030
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Fax | 559-278-3635
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT21517
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License Number State | CA
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