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NPI Code Detail

MEDICARE: MRS. TALYSA QUINTARA CRUZ KAKAS-LUJAN MSW, LSW, LSWAIC

MEDICARE: MRS. TALYSA QUINTARA CRUZ KAKAS-LUJAN MSW, LSW, LSWAIC
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 WorkerSWIA.SC.70053802WA
2104100000XSocial WorkerLSW-3322HI

General Provider Information

NPI Number : 1952251373
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TALYSA QUINTARA CRUZ KAKAS-LUJAN MSW, LSW, LSWAIC
Provider Business Mailing Address
First Line : 1202 N PEARL ST APT H105
Second Line :
City : TACOMA
State : WA
Zip : 98406-7976
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9600 VETERANS DR SW
Second Line :
City : TACOMA
State : WA
Zip : 98493-0003
Country : US
Telephone Number : 253-582-8440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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