Healthcare Provider Details

I. General information

NPI: 1598566994
Provider Name (Legal Business Name): MIA NICOLE CAJIGAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 NORIEGA ST
SAN FRANCISCO CA
94122-4046
US

IV. Provider business mailing address

956 S 14TH ST
EL CENTRO CA
92243-3807
US

V. Phone/Fax

Practice location:
  • Phone: 703-801-5672
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: