Individual
MR. DANIEL RAY LICON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
185 E 7TH AVE, CHICO, CA 95926-3356
(530) 332-4400
Mailing address
1125 SHERIDAN AVE, 48, CHICO, CA 95926
(530) 966-9198
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95030499
CA
Other
Enumeration date
02/19/2024
Last updated
06/24/2024
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