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General NPI Number Information
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NPI Number | 1568345478
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Entity Type | Individual
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Provider Name | JAMARA HICKS
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Gender | Female
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 2361 BASS LAKE RD APT 1024
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City | CAMERON PARK
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State | CA
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Zip | 95682-9638
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Country | US
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Telephone | 916-265-0910
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Fax |
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Provider Business Mailing Address
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Address Line | 5960 S LAND PARK DR # 887
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City | SACRAMENTO
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State | CA
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Zip | 95822-3313
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Country | US
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Telephone |
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Fax |
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | D552759ADC
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License Number State | CA
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