Provider Demographics
NPI:1710297692
Name:CICERONE, ALIZA DANIELLE (ND)
Entity Type:Individual
Prefix:DR
First Name:ALIZA
Middle Name:DANIELLE
Last Name:CICERONE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 SAN MARIO DR
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1604
Mailing Address - Country:US
Mailing Address - Phone:408-621-6718
Mailing Address - Fax:
Practice Address - Street 1:642 SAN MARIO DR
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1604
Practice Address - Country:US
Practice Address - Phone:858-226-4332
Practice Address - Fax:866-406-7540
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1778175F00000X
CAND620175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath