Individual
DAVID A DICICCO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5190 GOVERNOR DR, STE 108, SAN DIEGO, CA 92122-2847
(858) 546-1211
(858) 546-0411
Mailing address
5190 GOVERNOR DR, STE 108, SAN DIEGO, CA 92122-2847
(858) 546-1211
(858) 546-0411
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY5667
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY056670
—
CA
Enumeration date
09/13/2005
Last updated
07/08/2007
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