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General NPI Number Information
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NPI Number | 1184493835
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Entity Type | Individual
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Provider Name | ROSA CARMINA DIAZ NP
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Gender | Female
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Dates
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Enumeration Date | 12/21/2023
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 3580 WILSHIRE BLVD STE 2000
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City | LOS ANGELES
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State | CA
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Zip | 90010-2533
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Country | US
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Telephone | 212-381-1250
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Fax | 213-383-4803
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Provider Business Mailing Address
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Address Line | 3580 WILSHIRE BLVD STE 2000
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City | LOS ANGELES
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State | CA
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Zip | 90010-2533
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Country | US
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Telephone | 213-381-1250
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Fax | 213-383-4803
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 95107150
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 95107150
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95033456
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License Number State | CA
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