Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shannon Marie Hicks, PA-C

Individual provider Physician Assistant · NPI 1891556809

Shannon Marie Hicks, PA-C is a Physician Assistant in San Diego, California. Qualified in 2023, 3 years ago. Practices with Scripps Health, a 1,446-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California and New York.

Years since qualifying
3
Licensed in
CA, NY
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3811 Valley Centre Dr
San Diego, CA 92130-3318
Phone: (858) 554-7439
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA66047 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 031494 (NY)

Record details

NPI number1891556809
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 17, 2024
Last updated in NPPESMay 15, 2025
Certification dateMay 15, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Scripps Health — 1446 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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