Provider Demographics
NPI:1598948663
Name:PACHECO, DIANA P (BSE)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:P
Last Name:PACHECO
Suffix:
Gender:F
Credentials:BSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5245
Mailing Address - Country:US
Mailing Address - Phone:508-930-0723
Mailing Address - Fax:
Practice Address - Street 1:636 ROCK ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3438
Practice Address - Country:US
Practice Address - Phone:508-675-5778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator