Provider Demographics
NPI:1396635546
Name:DICARLO, GRACE DIANNE (PUBLIC HEALTH BS)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:DIANNE
Last Name:DICARLO
Suffix:
Gender:F
Credentials:PUBLIC HEALTH BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44349 LOWTREE AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4104
Mailing Address - Country:US
Mailing Address - Phone:661-228-0567
Mailing Address - Fax:
Practice Address - Street 1:1545 HOTEL CIR S STE 301
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3400
Practice Address - Country:US
Practice Address - Phone:619-310-5882
Practice Address - Fax:619-241-2678
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator