Healthcare Provider Details

I. General information

NPI: 1356811103
Provider Name (Legal Business Name): MARIA DE JESUS ALDACO JAUREGUI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2018
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

976 ENTRADA DR
SOLEDAD CA
93960-3555
US

IV. Provider business mailing address

976 ENTRADA DR
SOLEDAD CA
93960-3555
US

V. Phone/Fax

Practice location:
  • Phone: 831-800-4439
  • Fax:
Mailing address:
  • Phone: 831-800-4519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: