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General NPI Number Information
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NPI Number | 1669338984
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Entity Type | Individual
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Provider Name | MARTHA ALEJANDRA DIAZ
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Gender | Female
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 390 N EUCLID AVE
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City | UPLAND
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State | CA
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Zip | 91786-6031
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Country | US
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Telephone | 619-353-7050
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Fax |
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Provider Business Mailing Address
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Address Line | 3555 POLK ST
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City | RIVERSIDE
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State | CA
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Zip | 92505-1915
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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 |
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | CA
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