{
"Npi": {
"NPI": "1184493835",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DIAZ",
"FirstName": "ROSA",
"MiddleName": "CARMINA",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "DIAZ",
"OtherFirstName": "ROSA",
"OtherMiddleName": "CARMINA",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "ROSA CARMINA DIAZ RN",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "3580 WILSHIRE BLVD STE 2000",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90010-2533",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "213-381-1250",
"MailingAddressFaxNumber": "213-383-4803",
"FirstLinePracticeLocationAddress": "3580 WILSHIRE BLVD STE 2000",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90010-2533",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "212-381-1250",
"PracticeLocationAddressFaxNumber": "213-383-4803",
"EnumerationDate": "12/21/2023",
"LastUpdateDate": "06/25/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2084P0802X",
"TaxonomyName": "Addiction Psychiatry Physician",
"LicenseNumber": "95107150",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "390200000X",
"TaxonomyName": "Student in an Organized Health Care Education/Training Program",
"LicenseNumber": "95107150",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "95033456",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}