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General NPI Number Information
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NPI Number | 1033033410
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Entity Type | Individual
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Provider Name | DIANE MBONGOH DAIGA JR.
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Gender | Female
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Dates
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Enumeration Date | 08/07/2026
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Last Update Date | 08/07/2026
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Provider Practice Location Address
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Address Line | 2501, 1628 MARION BARRY AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20020
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Country | US
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Telephone | 202-866-7505
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Fax | 202-866-7505
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Provider Business Mailing Address
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Address Line | 7825 MISTLETOE DR APT 266
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City | ELKRIDGE
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State | MD
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Zip | 21075-7320
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Country | US
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Telephone | 202-866-7505
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Fax | 202-866-7505
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | DC
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