Individual
JUDITH GIACONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PHN, MA
Contact information
Practice address
11711 SAND CANYON RD, YUCAIPA, CA 92399-1742
(909) 389-3272
(909) 389-0772
Mailing address
35080 BUENA MESA DR, CALIMESA, CA 92320-1904
(909) 389-3272
(909) 389-0772
Taxonomy
Speciality
Code
Description
License number
State
163WC1400X
College Health Registered Nurse
Primary
242096
CA
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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