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General NPI Number Information
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NPI Number | 1568286425
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Entity Type | Individual
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Provider Name | AURA CARIDAD CERVANTES-DIEGO
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Gender | Female
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 104 WALNUT AVE STE 208
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City | SANTA CRUZ
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State | CA
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Zip | 95060-3929
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Country | US
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Telephone | 831-423-9444
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Fax |
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Provider Business Mailing Address
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Address Line | 15 COFFEY LN
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City | FREEDOM
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State | CA
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Zip | 95019-2717
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Country | US
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Telephone | 831-728-8713
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Fax |
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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 | CA
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