Jackie Dietz is a Clinical in San Diego, California. Jackie Dietz practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jackie Dietz is 1871611780. The last update date is 2007-07-08.
Jackie Dietz's current location address is 3020 Childrens Way # Mc5130, San Diego, California. You can contact this provider via phone number 6195333529 and fax number 6195333558. The mailing address for Jackie Dietz is 3020 Childrens Way # Mc5130, San Diego, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jackie Dietz |
|---|---|
| Address | 3020 Childrens Way # Mc5130, San Diego, California |
| Phone Number | 6195333529 |
| Fax Number | 6195333558 |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1871611780 |
|---|---|
| Provider Enumeration Date | 2007-03-27 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3020 Childrens Way # Mc5130 |
|---|---|
| City | San Diego |
| State | California (CA) |
| Post Code | 921234223 |
| Phone Number | 6195333529 |
| Fax Number | 6195333558 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCS19311 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Post Comment/ Review Below
What is the Jackie Dietz's unique identification number?
The Jackie Dietz has been assigned the NPI (National Provider Identifier) Number 1871611780 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical location address where Jackie Dietz's facilities are situated?
The facilities of Jackie Dietz are physically located at the following address: 3020 Childrens Way # Mc5130, San Diego, CA, 921234223.
What is Jackie Dietz's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jackie Dietz's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 1041C0700X.
On what date was the 1871611780 assigned to Jackie Dietz?
The Jackie Dietz was issued its 1871611780 on 2007-03-27, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Jackie Dietz most recently updated or revised?
The information pertaining to Jackie Dietz, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.