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General NPI Number Information
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NPI Number | 1164364204
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Entity Type | Organization
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Legal Business Name | DIAZ PSYCHOLOGICAL & FORENSIC SERVICES, PLLC
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 4539 N 22ND ST STE R
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City | PHOENIX
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State | AZ
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Zip | 85016-4639
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Country | US
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Telephone | 480-382-8860
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Fax |
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Provider Business Mailing Address
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Address Line | 4539 N 22ND ST STE R
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City | PHOENIX
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State | AZ
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Zip | 85016-4639
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. DESYRE DIAZ
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Credential | PSYD
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Telephone | 480-382-8860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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