Healthcare Provider Details

I. General information

NPI: 1477364339
Provider Name (Legal Business Name): SOPHIA DIPLACIDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 UNION ST STE 407
NATICK MA
01760-7700
US

IV. Provider business mailing address

171 MAIN ST STE 203B
ASHLAND MA
01721-1187
US

V. Phone/Fax

Practice location:
  • Phone: 508-655-2338
  • Fax: 508-650-9413
Mailing address:
  • Phone: 508-881-3029
  • Fax: 508-881-1752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: