Healthcare Provider Details

I. General information

NPI: 1144537473
Provider Name (Legal Business Name): CINDY M DIAZ MSW INTERN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CINDY M DIAZ ASW

II. Dates (important events)

Enumeration Date: 09/08/2010
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 PINE ST STE L
RED BLUFF CA
96080-3312
US

IV. Provider business mailing address

2458 ENGLAND ST
CHICO CA
95928-9402
US

V. Phone/Fax

Practice location:
  • Phone: 530-526-4640
  • Fax:
Mailing address:
  • Phone: 530-519-7963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: