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General NPI Number Information
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NPI Number | 1750236097
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Entity Type | Individual
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Provider Name | ALICIA M DERRICO
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Gender | Female
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 1095 STAFFORD WAY STE D
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City | YUBA CITY
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State | CA
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Zip | 95991-3333
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Country | US
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Telephone | 530-789-8987
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Fax |
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Provider Business Mailing Address
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Address Line | 1842 WHITE OAK DR
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City | YUBA CITY
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State | CA
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Zip | 95991-8216
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Country | US
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Telephone | 530-789-8987
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | CA
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