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General NPI Number Information
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NPI Number | 1548426380
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Entity Type | Individual
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Provider Name | DAVID PICELLA PHD, FNP, GS-C, CPG
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Gender | Male
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 836 N DEL SOL LN
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1105
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Country | US
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Telephone | 877-241-8200
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Fax | 909-245-1751
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Provider Business Mailing Address
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Address Line | 340 S LEMON AVE 1295
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City | WALNUT
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State | CA
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Zip | 91789-2706
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Country | US
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Telephone | 877-241-8200
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Fax | 909-245-1751
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | NP10299
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | CNS269
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP10299
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License Number State | CA
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