MEDICARE: DR. SICILY NONE JOSEPH PH.D

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
1	103TC0700X	Clinical Psychologist	15298	CA

General Provider Information

NPI Number	:	1649368283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SICILY NONE JOSEPH PH.D

Provider Business Mailing Address
First Line	:	128 E KATELLA AVE
Second Line	:	110
City	:	ORANGE
State	:	CA
Zip	:	92867-4836
Country	:	US
Telephone Number	:	714-287-8973
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 E KATELLA AVE
Second Line	:	110
City	:	ORANGE
State	:	CA
Zip	:	92867-4836
Country	:	US
Telephone Number	:	714-287-8973
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	12/14/2025

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