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General NPI Number Information
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NPI Number | 1861716722
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Entity Type | Individual
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Provider Name | MARCELA DIAZ-SMOIRE LMFTI
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Gender | Female
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Dates
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Enumeration Date | 03/22/2010
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | 2550 E FOOTHILL BLVD
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City | PASADENA
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State | CA
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Zip | 91107-3406
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Country | US
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Telephone | 626-590-9445
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Fax |
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Provider Business Mailing Address
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Address Line | 616 N FLORENCE ST
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City | BURBANK
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State | CA
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Zip | 91505-3021
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Country | US
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Telephone | 818-266-5329
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Fax | 818-567-0474
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT77521
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License Number State | CA
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