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NPI Code Detail

MEDICARE: MARWAN DIEKEN

MEDICARE: MARWAN DIEKEN
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
1172V00000XCommunity Health Worker
2106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1275117038
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARWAN DIEKEN
Provider Business Mailing Address
First Line : 9340 E STOCKTON BLVD
Second Line :
City : ELK GROVE
State : CA
Zip : 95624-1563
Country : US
Telephone Number : 916-509-8198
Fax Number : 916-509-8199
Provider Business Practice Location Address
First Line : 9340 E STOCKTON BLVD
Second Line :
City : ELK GROVE
State : CA
Zip : 95624-1563
Country : US
Telephone Number : 916-509-8198
Fax Number : 916-509-8199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2021
Last Update Date : 05/31/2024

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Directions to “ MARWAN DIEKEN ” Practice Location

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