MEDICARE: MRS. JENINE LYNN AGUON CABRERA DAMIAN 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
1	1041C0700X	Clinical Social Worker	LCSW-E-048	GU

General Provider Information

NPI Number	:	1952268443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENINE LYNN AGUON CABRERA DAMIAN LCSW

Provider Business Mailing Address
First Line	:	1270 N. MARINE CORPS DR. PMB 1053
Second Line	:	SUITE 101
City	:	TAMUNING
State	:	GU
Zip	:	96913
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	665 S MARINE CORPS DR STE 102
Second Line	:
City	:	TAMUNING
State	:	GU
Zip	:	96913-3572
Country	:	US
Telephone Number	:	671-989-1962
Fax Number	:	671-989-5579

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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