Active NPI
Jacqueline Diego-Medina, LCSW
- Clinical Social Worker
- El Paso, TX
National Provider Identifier
1558488460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 41732
- Practice address
- 5001 N Piedras St
El Paso, TX 79930-4210 - Phone
- (915) 564-6100
- NPI assigned
- Mar 24, 2007
- Last updated
- Jan 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 41732 | TX | |
| Social Worker | 104100000X | M-05991 | NM | |
| Clinical Social Worker | 1041C0700X | 41732 | TX | Primary |
Addresses
Primary practice location
5001 N Piedras St
El Paso, TX 79930-4210
Mailing address
294 Mountain Vista Rd.
La Union, NM 88021
Phone (915) 252-4174
Other practice location 1
294 Mountain Vista Rd.
La Union, NM 88021
Phone (915) 252-4174
Other names 1
- Ms. Jacqueline Diego
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-05991 | NM | MD | Social Worker |
| 41732 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609718400000",
"number": "1558488460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "294 MOUNTAIN VISTA RD.",
"city": "LA UNION",
"state": "NM",
"postal_code": "88021",
"telephone_number": "915-252-4174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 N PIEDRAS ST",
"city": "EL PASO",
"state": "TX",
"postal_code": "799304210",
"telephone_number": "915-564-6100"
}
],
"practiceLocations": [
{
"address_1": "294 Mountain Vista Rd.",
"address_purpose": "LOCATION",
"city": "La Union",
"state": "NM",
"postal_code": "88021",
"country_code": "US",
"telephone_number": "915-252-4174",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIEGO-MEDINA",
"first_name": "JACQUELINE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-24",
"last_updated": "2021-01-04",
"certification_date": "2021-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "41732",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "M-05991",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "41732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JACQUELINE",
"last_name": "DIEGO",
"prefix": "MS.",
"credential": "LMSW",
"code": "5",
"type": "Other Name"
}
]
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.