Individual
JACQUELINE C TRICARICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5620 W THUNDERBIRD RD STE B, GLENDALE, AZ 85306-4636
(602) 206-6262
Mailing address
14598 W WINDSOR AVE, GOODYEAR, AZ 85395-2037
(315) 439-8610
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
7785
AZ
363A00000X
Physician Assistant
0010-04192
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7785
—
AZ
Enumeration date
03/07/2013
Last updated
02/08/2022
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