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NPI Code Detail

MEDICARE: ALESSIA VITTORIA DUCA RN

MEDICARE: ALESSIA VITTORIA DUCA RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program390200000XCA
2363LF0000XFamily Nurse Practitioner95015159CA

General Provider Information

NPI Number : 1518593300
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALESSIA VITTORIA DUCA RN
Provider Business Mailing Address
First Line : 5220 MESADA ST
Second Line :
City : ALTA LOMA
State : CA
Zip : 91737-1742
Country : US
Telephone Number : 518-852-4198
Fax Number :
Provider Business Practice Location Address
First Line : 11262 CAMPUS ST
Second Line :
City : LOMA LINDA
State : CA
Zip : 92350-1727
Country : US
Telephone Number : 909-558-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2020
Last Update Date : 11/24/2021

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