Rigoberto Vasquez
Individual provider Active NPI Social Worker · Shelley, ID
NPI 1801219985 · NPPES record last updated Jan 27, 2014
Key facts
- NPI
- 1801219985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 926 E 800 N
Shelley, ID 83274-5303 - Phone
- (208) 520-4473
- NPI assigned
- Jan 27, 2014
- Sex
- Male
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ID | Yes |
Addresses
Primary practice location
926 E 800 N
Shelley, ID 83274-5303
Mailing address
926 E 800 N
Shelley, ID 83274-5303
Phone (208) 520-4473
Other providers in Shelley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2014. 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.