Healthcare Provider Details

I. General information

NPI: 1275961609
Provider Name (Legal Business Name): DIANA MARIE ALLOCCO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANA MARIE DICICCO RN-BSN

II. Dates (important events)

Enumeration Date: 10/22/2013
Last Update Date: 07/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

738 BANCROFT RD
WALNUT CREEK CA
94598-1531
US

IV. Provider business mailing address

241 FRANCISCO ST APARTMENT #2
SAN FRANCISCO CA
94133-2042
US

V. Phone/Fax

Practice location:
  • Phone: 925-938-7616
  • Fax:
Mailing address:
  • Phone: 703-772-4470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95000215
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024171070
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: