Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ivana Licon

Individual provider Other Technician · NPI 1659041044

Ivana Licon is an Other Technician in San Diego, California. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

501 W Broadway Ste 800
San Diego, CA 92101-3546
Phone: (855) 832-6727
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Other Technician (primary) Taxonomy 247200000X

Record details

NPI number1659041044
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 16, 2021
Last updated in NPPESSeptember 16, 2021
Certification dateSeptember 16, 2021
Mailing address7108 S Kanner Hwy, Stuart, FL 34997-7462

Other providers in San Diego