Diana Patricia Berruecos
Individual provider Active NPI Clinical Social Worker · Sacramento, CA
NPI 1235324070 · NPPES record last updated Dec 30, 2021
Key facts
- NPI
- 1235324070
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 2008 Morse Ave
Sacramento, CA 95825-2135 - Phone
- (916) 973-5300
- NPI assigned
- Sep 13, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29788 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
| Octave Behavioral Health PC | Past | Accepting new patients |
Interoperability endpoints
- dianaberruecos@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
2008 Morse Ave
Sacramento, CA 95825-2135
Mailing address
2008 Morse Ave
Sacramento, CA 95825-2135
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Sacramento, CA
- Christa Azilee Berri
- Vallesky Berrich
- Robin Howard Berrin
- Moses Jacob Berrios-Heredia
- Craig Eagan Berris
- Brigitte Lee Berry
- Carol Dawn Berry
- Kenneth Charles Berry III
- Niza Berry
- Roy A. Berry
All providers in Sacramento, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.