Provider Demographics
NPI:1528208543
Name:DICICCO, JOYCE N (LCSW, CSA)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:N
Last Name:DICICCO
Suffix:
Gender:F
Credentials:LCSW, CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:HEALTH & WELLNESS DEPARTMENT
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:619-532-6528
Mailing Address - Fax:619-532-7722
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:HEALTH & WELLNESS DEPARTMENT
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-532-6528
Practice Address - Fax:619-532-7722
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALSC13015104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker