Provider Demographics
NPI:1962159822
Name:HICKS, ALESHA DENISE (MS, GCG)
Entity type:Individual
Prefix:MS
First Name:ALESHA
Middle Name:DENISE
Last Name:HICKS
Suffix:
Gender:F
Credentials:MS, GCG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 WALKER AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-4300
Mailing Address - Country:US
Mailing Address - Phone:865-385-1206
Mailing Address - Fax:
Practice Address - Street 1:701 GATEWAY BLVD STE 380
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-7420
Practice Address - Country:US
Practice Address - Phone:510-831-3207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS