Individual
DANIEL ANTHONY LICONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 W ASHLAN AVE STE 100, CLOVIS, CA 93612-5627
(559) 420-5137
Mailing address
11150 W OLYMPIC BLVD STE 1160, LOS ANGELES, CA 90064-1826
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
09/06/2024
Last updated
06/10/2025
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