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NPI Code Detail

MEDICARE: MS. DIEGA M CABRERA MSW, LCSW

MEDICARE:  MS. DIEGA M CABRERA  MSW, 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 WorkerLW00005779WA
21041C0700XClinical Social WorkerL5034OR

General Provider Information

NPI Number : 1790715076
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIEGA M CABRERA MSW, LCSW
Provider Business Mailing Address
First Line : 272 NW MEDICAL LOOP STE E
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-5545
Country : US
Telephone Number : 541-440-3532
Fax Number : 541-440-3554
Provider Business Practice Location Address
First Line : 2700 NW STEWART PKWY
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-1281
Country : US
Telephone Number : 541-440-3532
Fax Number : 541-440-3554
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 01/08/2015

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Directions to “ MS. DIEGA M CABRERA MSW, LCSW” Practice Location

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