Provider Demographics
NPI:1285004150
Name:RICO, DANIELLE RENEE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RENEE
Last Name:RICO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 KEITH ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-2910
Mailing Address - Country:US
Mailing Address - Phone:559-583-7800
Mailing Address - Fax:
Practice Address - Street 1:222 KEITH ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-2910
Practice Address - Country:US
Practice Address - Phone:559-583-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-04
Last Update Date:2015-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)