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NPI Code Detail

MEDICARE: MS. NATALIE DIMIDJIAN LCSW

MEDICARE: MS. NATALIE DIMIDJIAN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker60573CA

General Provider Information

NPI Number : 1629106778
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NATALIE DIMIDJIAN LCSW
Provider Business Mailing Address
First Line : 1430 WILLOW PASS RD STE 100
Second Line :
City : CONCORD
State : CA
Zip : 94520-7946
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1430 WILLOW PASS RD STE 100
Second Line :
City : CONCORD
State : CA
Zip : 94520-7946
Country : US
Telephone Number : 925-313-9554
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 08/19/2020

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