Healthcare Provider Details

I. General information

NPI: 1700275559
Provider Name (Legal Business Name): GLORIA DIAZ ARNAL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2015
Last Update Date: 01/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

766 VALENCIA ST
SAN FRANCISCO CA
94110-1735
US

IV. Provider business mailing address

555 MIDDLEFIELD RD
PALO ALTO CA
94301-2124
US

V. Phone/Fax

Practice location:
  • Phone: 415-489-8816
  • Fax:
Mailing address:
  • Phone: 650-321-3325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number78216
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number78216
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number109706
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: