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General NPI Number Information
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NPI Number | 1982090759
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Entity Type | Individual
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Provider Name | NICOLE DEL GUERCIO
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Gender | Female
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 5601 DE SOTO AVE
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6701
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Country | US
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Telephone | 818-719-4396
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Fax |
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Provider Business Mailing Address
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Address Line | 23100 AVENUE SAN LUIS APT 252
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-1075
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Country | US
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Telephone | 310-496-9413
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 811337
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 811337
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License Number State | CA
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