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NPI Code Detail

MEDICARE: ANGELICA DIAZ

MEDICARE: ANGELICA DIAZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225C00000XRehabilitation Counselor

General Provider Information

NPI Number : 1376101972
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELICA DIAZ
Provider Business Mailing Address
First Line : 11731 TELEGRAPH RD STE G
Second Line :
City : SANTA FE SPRINGS
State : CA
Zip : 90670-6819
Country : US
Telephone Number : 562-942-8256
Fax Number :
Provider Business Practice Location Address
First Line : 11731 TELEGRAPH RD STE G
Second Line :
City : SANTA FE SPRINGS
State : CA
Zip : 90670-6819
Country : US
Telephone Number : 562-942-8256
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2019
Last Update Date : 11/06/2019

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Directions to “ ANGELICA DIAZ ” Practice Location

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