Individual provider · NPI-1

Maricia Ditgen

Rehabilitation Practitioner · Roseville, CA

NPI number1205468089
StatusActive
Last updated in NPPESOct 1, 2025

Details

NPI
1205468089
Entity type
Individual (NPI-1)
Name
Maricia Ditgen
Sex
Female
Sole proprietor
No
Enumeration date
Feb 10, 2020
Certification date
Oct 1, 2025
Last updated
Oct 1, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225400000X Rehabilitation Practitioner–CAYes
171M00000X Case Manager/Care Coordinator––
175T00000X Peer SpecialistMPSS-ALDZXSCA
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

101 Cirby Hills Dr
Roseville, CA 95678-4360

Phone 169-548-9203

Mailing address

101 Cirby Hills Dr
Roseville, CA 95678-4360

Phone 916-545-0690

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