Individual provider Active NPI

Diana Marie Camacho, MSW, LCSW

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1174633606
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23761 Issued in CA
Practice address
3701 J St Ste 201
Sacramento, CA 95816-5542
Phone
(855) 354-2242
NPI assigned
Aug 30, 2006
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 23761 CA Primary

Addresses

Primary practice location

3701 J St Ste 201
Sacramento, CA 95816-5542

Mailing address

1860 Howe Ave Ste 440
Sacramento, CA 95825-1098
Phone (916) 569-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201120001416 CA Practitioner - Clinical Social Worker 4981015070 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elica Health Centers Current Accepting new patients
Elica Health Centers CurrentSince Oct 22, 2020 Accepting new patients
Elica Health Centers Clinical CurrentSince Oct 22, 2020 Accepting new patients

Locations

1750 Wright St
Ste 1
Sacramento, CA 95825

1860 Howe Ave
Ste 440
Sacramento, CA 95825

3701 J St
Ste 201
Sacramento, CA 95816
Phone (916) 454-0184

1276 Halyard Dr
West Sacramento, CA 95691
Phone (530) 865-5544

155 15th St
Ste A
West Sacramento, CA 95691
Phone (916) 375-8981

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1174633606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 J ST STE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165542",
            "telephone_number": "855-354-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "23761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.