Healthcare Provider Details

I. General information

NPI: 1295556256
Provider Name (Legal Business Name): ALANNA PENECALE IORIO AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 NORDAHL RD STE 300
SAN MARCOS CA
92069-3599
US

IV. Provider business mailing address

1510 E HERNDON AVE STE 310
FRESNO CA
93720-3393
US

V. Phone/Fax

Practice location:
  • Phone: 760-747-8935
  • Fax: 760-747-7951
Mailing address:
  • Phone: 559-326-1222
  • Fax: 559-421-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95032680
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: