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General NPI Number Information
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NPI Number | 1013820356
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Entity Type | Organization
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Legal Business Name | PICCS WITH GRACE INC.
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 5450 SWINGSTONE DR
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City | HEMET
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State | CA
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Zip | 92545-6125
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Country | US
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Telephone | 951-438-0577
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Fax |
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Provider Business Mailing Address
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Address Line | 5450 SWINGSTONE DR
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City | HEMET
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State | CA
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Zip | 92545-6125
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Country | US
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Telephone | 951-438-0577
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Fax |
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Authorized Official
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Title or Position | PICC RN
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Name | ALONZO BURRELL
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Credential | RN
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Telephone | 951-438-0577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number |
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License Number State | NULL
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