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General NPI Number Information
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NPI Number | 1396635546
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Entity Type | Individual
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Provider Name | GRACE DIANNE DICARLO PUBLIC HEALTH B.S
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Gender | Female
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 1545 HOTEL CIR S STE 301
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City | SAN DIEGO
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State | CA
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Zip | 92108-3400
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Country | US
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Telephone | 619-310-5882
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Fax | 619-241-2678
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Provider Business Mailing Address
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Address Line | 44349 LOWTREE AVE STE 111
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City | LANCASTER
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State | CA
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Zip | 93534-4104
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Country | US
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Telephone | 661-228-0567
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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