Provider Demographics
NPI:1215124953
Name:IOCCO, JANET L (PA-C)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:IOCCO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JAN
Other - Middle Name:L
Other - Last Name:IOCCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:2491 SAN FERNANDO CT
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1649
Mailing Address - Country:US
Mailing Address - Phone:909-762-1650
Mailing Address - Fax:
Practice Address - Street 1:311 WINSTON ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1519
Practice Address - Country:US
Practice Address - Phone:909-762-1650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2021-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical