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General NPI Number Information
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NPI Number | 1437639796
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Entity Type | Individual
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Provider Name | DAIANA BUCIO MS
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Gender | Female
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 08/16/2018
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Provider Practice Location Address
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Address Line | 181 S BUENA VISTA ST
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City | BURBANK
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State | CA
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Zip | 91505-4504
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Country | US
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Telephone | 818-748-4748
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Fax |
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Provider Business Mailing Address
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Address Line | 1394 MIDVALE AVE APT 209
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City | LOS ANGELES
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State | CA
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Zip | 90024-6202
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Country | US
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Telephone | 707-494-7084
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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 | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | GC001011
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License Number State | CA
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