Healthcare Provider Details

I. General information

NPI: 1083589311
Provider Name (Legal Business Name): ALLYSON LYNN PICONE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

398 S GREEN VALLEY RD
WATSONVILLE CA
95076-3099
US

IV. Provider business mailing address

398 S GREEN VALLEY RD
WATSONVILLE CA
95076-3099
US

V. Phone/Fax

Practice location:
  • Phone: 831-724-7525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number67392
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: