MEDICARE: CARRIE DIERINGER TAFFEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	ASW134344	CA

General Provider Information

NPI Number	:	1104670553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE DIERINGER TAFFEL

Provider Business Mailing Address
First Line	:	PO BOX 206
Second Line	:
City	:	SAN GERONIMO
State	:	CA
Zip	:	94963-0206
Country	:	US
Telephone Number	:	510-426-5177
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 24TH ST
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94804-1804
Country	:	US
Telephone Number	:	510-412-9200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2024
Last Update Date	:	04/16/2026

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Directions to “ CARRIE DIERINGER TAFFEL ” Practice Location

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