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NPI Code Detail

MEDICARE: JACQUELINE DELPHINE DI GIACOMO

MEDICARE:   JACQUELINE DELPHINE DI GIACOMO
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2106H00000XMarriage & Family Therapist72213CA

General Provider Information

NPI Number : 1659652139
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE DELPHINE DI GIACOMO
Provider Business Mailing Address
First Line : 6147 SUTTER AVE
Second Line : THE WHITE HOUSE COUNSELING CENTER
City : CARMICHAEL
State : CA
Zip : 95608-2738
Country : US
Telephone Number : 916-971-7640
Fax Number : 916-971-5711
Provider Business Practice Location Address
First Line : 6147 SUTTER AVE
Second Line : THE WHITE HOUSE COUNSELING CENTER
City : CARMICHAEL
State : CA
Zip : 95608-2738
Country : US
Telephone Number : 916-971-7640
Fax Number : 916-971-5711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2011
Last Update Date : 07/15/2016

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Directions to “ JACQUELINE DELPHINE DI GIACOMO ” Practice Location

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