Healthcare Provider Details

I. General information

NPI: 1093440323
Provider Name (Legal Business Name): HURIELA CRUZ DIEGO BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HURIELA DIEGO CASTILLO MAIDEN

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 13TH ST
MERCED CA
95341-6211
US

IV. Provider business mailing address

4205 W FIGARDEN DR
FRESNO CA
93722-6051
US

V. Phone/Fax

Practice location:
  • Phone: 209-381-6800
  • Fax:
Mailing address:
  • Phone: 559-221-1680
  • Fax: 559-221-4336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: