| Doctor Name: | JUDITH GIACONA |
| NPI Number: | 1033418108 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, PHN, MA |
| License Number: | 242096 |
| Business Practice Address: | 11711 Sand Canyon Rd Yucaipa, CA - 923991742 |
| Business Phone Number: | 9093893272 |
| Business Fax Number: | 9093890772 |
| Mailing Address: | 35080 Buena Mesa Dr, CALIMESA |
| State: | CA |
| Postal Code: | 923201904 |
| Phone Number: | 9093893272 |
| Fax Number: | 9093890772 |
| NPI Enumeration Date: | 03/15/2011 |
| NPI Last Update Date: | 03/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1400X |
| License Number: | 242096 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | College Health |
| Taxonomy Definition: | |