Individual provider · NPI-1

Daniel Anthony Licona

Day Training/Habilitation Specialist · Clovis, CA

NPI number1033944277

StatusActive

Last updated in NPPESJun 10, 2025

Details

NPI: 1033944277
Entity type: Individual (NPI-1)
Name: Daniel Anthony Licona
Sex: Male
Sole proprietor: No
Enumeration date: Sep 6, 2024
Certification date: Jun 10, 2025
Last updated: Jun 10, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
373H00000X	Day Training/Habilitation Specialist	–	–	Yes
106S00000X	Behavior Technician	–	–
171M00000X	Case Manager/Care Coordinator	–	–
172V00000X	Community Health Worker	–	–

Practice location

90 W Ashlan Ave Ste 100
Clovis, CA 93612-5627

Phone 559-420-5137

Mailing address

11150 W Olympic Blvd Ste 1160
Los Angeles, CA 90064-1826

Other practice locations

11150 W Olympic Blvd Ste 1160
Los Angeles, CA 90064-1826

Phone 510-397-2851

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