Individual
JASON ANTHONY SICURELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
161 N DATE ST, ESCONDIDO, CA 92025-3405
(760) 745-7786
Mailing address
7936 GOLD COAST DR, SAN DIEGO, CA 92126-3438
(480) 341-7514
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
229957
CA
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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