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General NPI Number Information
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NPI Number | 1366332819
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Entity Type | Individual
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Provider Name | YANINA DIAZ
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Gender |
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 510 W 1ST AVE
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City | TOPPENISH
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State | WA
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Zip | 98948-1564
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Country | US
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Telephone | 509-865-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 4522 FLORA ST
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City | MONTCLAIR
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State | CA
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Zip | 91763-3604
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Country | US
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Telephone | 909-294-0602
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | DERE.RR61671143
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License Number State | WA
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