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General NPI Number Information
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NPI Number | 1982350989
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Entity Type | Individual
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Provider Name | DIANA RUIZ MILLAN
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Gender | Female
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Dates
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Enumeration Date | 02/28/2022
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 3161 DWIGHT RD
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City | ELK GROVE
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State | CA
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Zip | 95758-6456
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Country | US
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Telephone | 818-427-7141
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 S MAYFLOWER AVE
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City | MONROVIA
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State | CA
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Zip | 91016-4066
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Country | US
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Telephone | 209-289-1074
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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