Individual
BRET J BACCIOCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5000 VAN NUYS BLVD STE 314, SHERMAN OAKS, CA 91403-1852
(818) 783-2396
(818) 783-2467
Mailing address
5000 VAN NUYS BLVD STE 314, SHERMAN OAKS, CA 91403-1852
(818) 783-2396
(818) 783-2467
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT4252
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT4252
CA LICENCE
CA
Enumeration date
01/22/2007
Last updated
09/28/2011
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