Provider Demographics
NPI:1518367796
Name:TOPETE, DIEGO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DIEGO
Middle Name:
Last Name:TOPETE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6250 SANTA TERESA BLVD APT 220
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1438
Mailing Address - Country:US
Mailing Address - Phone:831-821-9121
Mailing Address - Fax:
Practice Address - Street 1:1254 CABERNET DR
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:CA
Practice Address - Zip Code:93926-9421
Practice Address - Country:US
Practice Address - Phone:831-821-9121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1119121041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical