Individual
STACI ANN DIFAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14445 OLIVE VIEW DR, SYLMAR, CA 91342-1437
(747) 210-4343
Mailing address
24455 MONTEVISTA CIR, VALENCIA, CA 91354-1221
(818) 588-9389
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
808709
CA
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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