Provider Demographics
NPI:1770632846
Name:GIGLIO, JOHN A (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:GIGLIO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2181 S EL CAMINO REAL
Mailing Address - Street 2:SUITE 305
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6220
Mailing Address - Country:US
Mailing Address - Phone:760-966-1286
Mailing Address - Fax:760-966-1911
Practice Address - Street 1:2181 S EL CAMINO REAL
Practice Address - Street 2:SUITE 305
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6220
Practice Address - Country:US
Practice Address - Phone:760-966-1286
Practice Address - Fax:760-966-1911
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY7708103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP7708AMedicare PIN