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General NPI Number Information
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NPI Number | 1265396964
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Entity Type | Individual
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Provider Name | JOSEPH ANGELO DECECCO
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Gender | Male
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 227 S HALCYON RD STE 101
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3174
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Country | US
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Telephone | 805-801-2231
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 BELLO ST
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City | PISMO BEACH
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State | CA
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Zip | 93449-2320
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Country | US
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Telephone | 717-364-8419
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 160207
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License Number State | CA
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