Dicicco, David A

Dicicco, David A is an individual health care provider with primary practice located at 5190 Governor Dr Ste 108, San Diego CA 92122-2847. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Dicicco, David A can be contacted via phone (858) 546-1211.

Contact Information

Primary practice address
5190 Governor Dr Ste 108 San Diego CA 92122-2847
Fax: (858) 546-0411
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY5667 California

Profile Details

NPI number 1669467015
LBN Legal business name Dicicco, David A
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Jul 13th, 2026 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669467015 NPPES
California MEDICAID PSY056670

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