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Individual

ALYCIA DE LUCIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
92 ARGONAUT, SUITE 205, ALISO VIEJO, CA 92656-4116
(949) 916-8868
Mailing address
92 ARGONAUT, SUITE 205, ALISO VIEJO, CA 92656-4116
(949) 916-8868

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
591974
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33-0150193
MEDI-CAL
CA
Enumeration date
02/04/2016
Last updated
02/04/2016
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