Healthcare Provider Details

I. General information

NPI: 1750236097
Provider Name (Legal Business Name): ALICIA M DERRICO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 STAFFORD WAY STE D
YUBA CITY CA
95991-3333
US

IV. Provider business mailing address

1842 WHITE OAK DR
YUBA CITY CA
95991-8216
US

V. Phone/Fax

Practice location:
  • Phone: 530-789-8987
  • Fax:
Mailing address:
  • Phone: 530-789-8987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: