Healthcare Provider Details

I. General information

NPI: 1750929956
Provider Name (Legal Business Name): MARGARITA PALOMA AGUIRRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2019
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 EMERALD BAY RD STE A2
SOUTH LAKE TAHOE CA
96150-6434
US

IV. Provider business mailing address

924 EMERALD BAY RD STE A2
SOUTH LAKE TAHOE CA
96150-6434
US

V. Phone/Fax

Practice location:
  • Phone: 530-544-2111
  • Fax:
Mailing address:
  • Phone: 530-544-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW138951
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: