Clarissa Laqui Dimacali, CNA, HOME HEALTH AID
Individual provider Active NPI Nurse's Aide · Pacifica, CA
NPI 1346593258 · NPPES record last updated Oct 17, 2012
Key facts
- NPI
- 1346593258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- 0039232800117875 (CA)
- Practice address
- 50 W. Manor Dr # 1393
Pacifica, CA 94044 - Phone
- (650) 498-7442
- NPI assigned
- Oct 17, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0039232800117875 | CA | MD | Nurse's Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 0039232800117875 | CA | Yes |
Addresses
Primary practice location
50 W. Manor Dr # 1393
Pacifica, CA 94044
Mailing address
P.O. Box 1393
Pacifica, CA 94044
Phone (650) 438-9347
Other providers in Pacifica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2012. 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.