Individual
DANIEL RICHARD CIOCCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
9660 HAVEN AVE STE 203, RANCHO CUCAMONGA, CA 91730-5897
(909) 368-0566
Mailing address
7770 GARNET ST, RANCHO CUCAMONGA, CA 91730-2109
(909) 638-3985
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95012532
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95012532
AGACNP LICENSE NUMBER
CA
01
—
95134721
RN LICENSE NUMBER
CA
Enumeration date
08/29/2019
Last updated
08/29/2019
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